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How Patients Choose a Dentist

Over and over again you’ve heard me say that “a Dental Practice is just a small consumer driven business”.  As such, nothing happens unless the patient (consumer) says yes.  If you consistently see the back of people’s heads as they move on down the street to the next dentist on the block, you’re missing an important ingredient.   You need to consider giving patients more of what they want rather than what you want.  A few years back a doctoral thesis researching some 65,000 people made “what consumers want” a no brainer.  I want to give you the list that outlines the very essence of what it takes to be a Super General Practice with unlimited growth potential.  Forget the guys hawking the next greatest, “bestest” new marketing whatchamacallit and start getting back to the future.  Armed with this list, any practice should be able to increase new patients by increasing direct referrals.  The ripple effect of incorporating this into every minute of your practice day means you are embracing consumerism and capacity:  Giving patients what they want, when they want it, at a price they can afford.  The following list is not given in order of importance, and if you think about it, this is like a “success” recipe.  Leave out one ingredient, and you will not get what you expected.

  1. Prompt New Patient Exam:  As we go through this list, keep in mind that the original document was almost a thousand pages.  We will attempt to give the overall essence of each point.  You will notice that this is not a cleaning, just an exam.  The consumers filling out this survey indicated that the time needed to be within 24-48 hours of the phone call.  In addition they also added a caveat:   It needed to be either early (7-9AM), late (3-6PM) or on Saturday.  We call these “Peak Demand Times”.  If you do not have any peak demand times within the next few days, you shouldn’t market and you need to expect a lot of cancellations and no-shows.  Lack of peak demand times flies in the face of consumerism:  Giving the consumer what they want, when they want it, and at a price they can afford.
  2. Staff warm and helpful.  Keep in mind as you read each point that only the consumer gets to vote.  There is probably not one office that would say they were not “warm and helpful”.   It doesn’t matter what you think, perception is everything.  With the onslaught of social media you can’t escape being reviewed and reviled by everyone.  Everyone has an opinion and most will post it on Twitter, Facebook, and their Blog’s.  The average disgruntled patient will not say anything to you, while letting everyone they know, or who they have connected with online know, that this is a terrible place to go.  I recommend that you institute our feedback strategy of the “Comment Card”, and go to: (for any conversation about you or your office), (for any forum mentioning your name), (for real time mentions of you), and (for topics, or emails pertaining to any topic you choose and forward it to your email).
  3. Highest standards of sterilization and general cleanliness of your office.  This is a little counter intuitive in that it was the subjective “cleanliness” of the office they most cited.  Walt Disney called it “5 Sensing”.  He would routinely take a person, blind fold them, and help them into a ride.  He wanted to know what they heard, smelled, tasted, and touched.  He knew that the “senses” created either a good or poor experience in his theme parks.  In much the same way, how our practices look, how clean they are, how they smell, and what our patients hear, influences how we meet their needs.  If your office has bugs in the lights, and a dirty bathroom, you are not meeting the expectations of your patients.  Remember that everything is marketing, and new patients are constantly comparing your office, your staff, and your systems to other practices they have visited.  Everything has to be perfect.
  4. Up to date facility.  You will notice that they didn’t say new.  In the text they mentioned clean or new carpet, freshly painted walls, no stains on the ceiling tiles, clean windows, trimmed and neat landscaping, easy access, etc.  You get the idea.  Not new, but in like-new condition.  Unless your patient is a Patterson or Schein rep, they do not know the difference between a five-year-old chair and a brand new chair, as long as both are clean.
  5. Post op phone calls.  These have been around forever, yet few doctors do them.  When they do, it is delegated to a staff member and not actually the treating hygienist or doctor.  Big mistake.  If you want to be noticed and talked about, do what others do not do.  You want to be far from “average” in the eyes of your patients.  Each of these items creates the level of expectation you need to achieve in order to get a new patient, have them show up, and refer everyone they know.  If you fall short on any of these, you will fall flat in the production area of growth.  I not only did my own post-op phone calls but I took it a step farther.  In an effort to stay ahead of my partners, I started running off the next day’s schedule for everyone so I could identify all of the new patients.  I would then call each new patient and say:  “Hello, this is Dr. Abernathy.  I understand that you are coming in tomorrow for a ___________________________.  I was just calling to see if there was any question or anything I could do make your appointment go more smoothly?”  Most of the time I thought that the line had gone dead.  They were so impressed and overwhelmed that they were speechless.  This one thing almost eliminated all of our cancellations and no-shows in hygiene.  I can remember the first day after I had made the calls.  One of my partners beat me to the hygiene room only to be rebuked when the patient said:  “Oh, I was hoping to see Dr. Abernathy.”  It worked so well that patients that were checked on days or locations when I was not present allowed the other doctor to diagnose them, but insisted on seeing me for the treatment.  It was almost like they had been referred by a close friend.  Try it, you’ll like it.
  6. Post-op instructions.  In additions to the verbal explanations, these consumers commented that they wanted to be sure that the doctor or staff member took the time to explain and answer all of their questions.  In fact, they were adamant in their request that the staff do this.  They said that often times they did not want to look stupid in front of the doctor, so they felt more comfortable having the staff explain treatment and answer all of their questions prior to having the doctor come in.  We have all seen this.  The doctor completes the case presentation while the financial secretary, assistant, or hygienist takes notes, and then asks if the patient has any questions.  They say “No”.   The doctor excuses themselves, only to have the patient turn to the staff member and ask questions about this and that.  Keep in mind that they feel like the staff member has no reason to push dentistry onto them, while most think that the doctor is just looking to make another payment on their car.  In addition to the verbal explanations, the patient wanted to take home general information about the procedure as well as particular post-op instructions pertinent to them.  If you would like to see my written post-op instructions just email me and ask.
  7. Personal hygiene of the doctor and staff.  This one is interesting.   Let’s start with hair.  If your hair is short, but when you lean forward to look into the patient’s mouth and it shifts forward, they want it tied back or covered.  Even short hair can do this and patients feel like “stuff” could fall into their mouths as the hair shifts.  Bottom line:   Cover it up or tie it back.  They also mentioned that if you have body piercings other than a single ear ring per side they do not want to see it.  Several consumers said they don’t think people that would have a tongue pierced, nose, eyebrow, etc., are clean enough to work in a dental office.  The bottom line:  If you have piercings, take them out for work.  The final area involved tattoos.  They wanted all tattoos covered up so they did not show.
  8. Quality dentistry in the mouths of the Doctors and Staff members.  A lot of the people surveyed said that they were surprised at how a lot of staff members and doctors had “dingy” un-bleached teeth with old black mercury fillings visible.  If you want your productivity to take off, make sure that you and your staff have the finest up to date dentistry in their own mouths.  We also need to do a little policing as far as personal hygiene, dress, and breath.  If you have a doctor or staff member that looks like they sleep in their scrubs, and smell like the north end of a south bound horse, you need to put on your big girl panties and deal with this.  This goes for the smokers in the crowd.  There is no place in a dental office for someone who smells like cigarette smoke.
  9. Hours.  Remember the little bit we already mentioned about peak demand times and Saturdays?  You guessed it.  Consumers hate your hours:  Monday-Thursday 8-5.  In fact this was one of the most important and oft mentioned reasons they chose or changed dentists.  Corporate practices along with a new generation of young dentists who will do whatever it takes to give the patients a more convenient dental visit will literally put you out of business. The day of business as usual is gone, and the new economy demands that you change to meet or exceed the expectations of your patients.
  10. Location.  Success in dentistry, just like any other consumer driven business, is dependent upon location, location, location.  With 92% of all appointments made by a female, it only makes sense that we should try to be located where females frequent.  The 1950’s style practice hidden away in a multi-story cluster of medical offices and other dentists, with no visibility or signage, will guarantee a slow death spiral of new patients and productivity.  We need the visibility and hours to secure a reasonable number of new patients (50 -75 per doctor per month for a general practice).  It never fails to frustrate me at the lack of understanding of some doctors who have been in practice for years.  They can’t understand why, after having ten or fifteen good years, they can’t seem to maintain a good overhead, new patient numbers, and productivity.  Take the time to go to and look at where you live and whom you are likely to have to inspire as a patient.  This is a wakeup call for all of those thinking that it’s just a down economy that is the cause.  Change or die.  When you are done with change, you are done.
  11. Being on time every time.  There is a double standard in dentistry that upsets consumers:  You expect patients to show up on time, but you are never on time.  You don’t like managed care, but when purchasing medical benefits for your staff and family you choose a “managed care” medical insurance plan.  You blow your lid when patients can’t afford your treatment plans but you have maxed out every credit card you own.  It’s called consumerism and integrity.  Patients deserve for this double standard to go away.  Not being on time is a symptom of a lack of proper treatment planning and day-to-day systems.  Patients are talking.  Are you listening?
  12. Well explained treatment plans and financial options.  Today patients are going to follow through with treatment options based on four primary things:  Fear, money, time, and trust.  You should offer nitrous and sedation to every patient.  You should have consumer hours with lots of peak demand times.  You and your staff need to inspire patients in order to create a lifetime association.  Finally, we have to help patients fit their treatment into their budgets.  Step one is to understand that Care Credit is not necessarily the best company nor is any one company sufficient to satisfy the needs of your practice.  Consider adding at least one of these additional companies for your office:,,  Also keep in mind that when a patient is denied a loan, be sure and ask the company how much they would loan.  Just because they won’t loan $2500 doesn’t mean they won’t loan $2000.  Next, call another finance company and get the rest.  We have even had offices call in the morning and get a no, and call again on the same afternoon or different day get a yes.  It all depends on the company’s computers, money lent, and risk of outstanding loans.  It can change in minutes.  You might even find that a Friday when most doctors are not open is a great time to submit an inquiry.  There are not as many loans to compete with you.  We have to become experts at finance acquisitions for our patients.  Get this down and you will have unlimited growth potential.  As far as “well explained treatment plans”, it is much like post-op instructions.  We have to take the time to explain the various ways the treatment can be delivered and how that affects their financial and oral health.
  13. Consumers shop.  I actually had a front desk person turn to another staff member, after hanging up and conversing with a patient about money, and say:   “This job would be great if I didn’t have to deal with these stupid patients.”  Are you kidding me?  Who pays your salaries?  It’s not the doctor.  It’s the patients that spend their hard earned money in your office.  Take and divide the number of new patients into your monthly production to get the “production per new patient”.  I know that you don’t actually produce this on “each” new patient, but “per” new patient.  This number for the average dental practice is about $1,100 per new patient.  A well run general practice will be about $2,500/new patient.  If your practice does $3,000 or more, then you are in the “boutique” area with more crown and bridge and a predominately adult patient base.  Whatever it is, you need to see that denomination on the fore head of every patient you talk to.  Consider this.  You will either inspire or drive off a patient in the first 3 seconds of your initial contact.  If the average practice has 25 new patients per month that means you have 75 seconds per month to make enough to pay the bills and make a profit.  The patients you don’t inspire will go down the street to have their work done, and go online to tell everyone they are linked with to avoid your practice like the plague.

That’s it.  This is the “not so quick but dirty truth of why patients are either choosing you as a dentist (or choosing to leave you)”.  One more point.   While you now have a check list to help you successfully give patients what they want, you may be missing the most important point of this article.  Dentists are known to have a rare disease:  The Shiny Object Obsession.  Noticeably missing is nothing about lasers, implants, cosmetics, Cerec or E4D, any number of great toys you spend your hard earned money on.  It’s as if you believe that there is some instrument or piece of equipment or course that will stem the tide of failure.  The secret is and has always been your ability to inspire consumers through your people skills, systems, and staff.  Technology is great, but it will never take the place of “serving” your patients.

Michael Abernathy, DDS
[email protected]