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More Competitive Than You Thought

Over and over, I am asked why a particular office or doctor is struggling to compete in todays ever-changing environment. I know you have probably read articles where I have taken the time to go over Demographics, but let’s take just a moment and flesh this out a little more. Before you read on, go to, click on Resource Center, and then “Dentistics”, enter your zip code and write down the ratio of Dentists to Population. I will do the same and for this example I will be using: Allen, Texas, 75013. Next, go to and enter your zip code and write down the total population number, the male to female ratio, median age and medium household income along with the race demographics (you can do a further search of age demographics or any other analytic for your area if you choose). Once you have done all of this, come back and let’s look at the numbers and their effect on your growth and practice stats.

Allen, Texas 75013: One of the fastest growing towns in Texas, high income of over $100,000 per household (national average is $41,000), and a population of about 12,000 in that zip code (there are three more in Allen). In fact, if you look up this zip code you will see it lands in the top 10% for almost every population demographic: Percentage of homes lived in by owners (few rentals), number in the population with a college degree (high dental IQ), professional jobs (money to spend), average household size (lots of kids), and the highest in married population at 81.3%. It is the ideal American middle-class town with great schools, no crime, and everyone driving a new car. Truly, everything is perfect until we look at the competition: There is one dentist for every 64 people (ratio = 1:64). You literally cannot make a living in “paradise”.

Now, do the same thing for your location. How does it look? What changes would you be willing make to take into account what these population and growth trends tell you?

Ideal demographics: 1:2,000 dentist to patient ratio because anything less means you will have to be better by working more consumer friendly hours, providing a wider range of services (ortho, pedo, implant, sleep apnea, implants, etc.), and appeal to a wider range of consumers. Trends and demographics provide the map by which you navigate your practice growth, yet 90%+ of the dentists we speak to couldn’t tell you their new patient numbers, production/collection and profit from last month, let alone the demographics they operate in.
Let’s go a little further. Let’s also assume that your demographics are not ideal (most of us have been where we are so long that the demographics have changed or if you are young, you’ve already made the mistake of starting a practice or career in the wrong place). Over and over we see doctors take poor demographics coupled with challenging competition numbers and make it far worse. Here are just a few common obstacles to mull over:

• They fail to embrace consumerism: Giving patients what they want, when they want it, at a price they can afford.
• They are not “in-network” for the insurance plans purchased by major companies (employers) in their draw area. The average insurance utilization in the U.S. for Dentistry is over 60%. So, if your ratio was 1:1,000 and your strategy was to not be in-network, you need to eliminate 60%+ of that 1,000 because they are not coming in and if they do they will certainly not stay. Just ask your front desk employees how many calls they get each month from people asking if you are in-network, and how quickly they hang up when they find out you are not. According to the ADA, 93% of dentists are in network for PPO’s.
• You do not see kids below 20 years of age. Great strategy, but the average percentage of the population of the U.S. below age 20 is 28%. Do this and you can take the same example and realize that you are not going to see 280 of the 1:1,000 in your zip code. But it is worse than that. You probably will never get to see their parents or grandparents because some smart dentist with Friday and Saturday hours will be seeing all of them (and then the people they will refer).
• You decide that you will not work any hours except Monday through Thursday from 8-5. As I look at Allen, Texas, I know that the average age is 31.8 so most of the adults in Allen work. We have dual income families with a couple of kids that go to school and because there are few if any dentists open Friday and Saturday they choose to do their dentistry near work rather than near their home, so once again the ratio isn’t 1:64. It is always worse if you don’t choose consumer hours.
• In the U.S., an average of 20% of the population moves every year. But you have decided that marketing doesn’t work, isn’t ethical, or costs too much so you don’t even try to replace the 20% that moved out of your office with new blood. Would you even know how to market?
• You have a web site but you have chosen to not participate in social media, as if that was possible. People will talk about you whether or not you participate or become proactive enough to mitigate the negative comments about your practice. Seldom, if ever, do I hear a doctor that is not surprised when I tell him that people are saying things that are not very nice about them on Ucompare, Rate MDs, Yelp, Healthgrades, etc. They are clueless as to its impact or that there is anything negative about them on the Internet.
• Their magazines and last remodel are older than their dental degree. Every time someone walks into your office they are comparing what they see, what they smell, what they feel, how they are treated (kept waiting, not addressed properly, the culture of the office is off,) with any other office they have visited and for a lot of us, we are coming up short. The patient doesn’t have a checklist, it just doesn’t feel right. So they vote with their feet and you don’t get referrals or 90% case acceptance like you should.
• You know that you don’t have it going on if the sole reason you have a defibrillator is for your staff. If the demographics say the median age is 32 but your staff’s median age is 65, it is unlikely that you will attract the majority of patients in your demographic. Doctors attract patients about 10-15 years on each side of their own ages, so longevity can sometimes rule out growth unless you stage everything you do to be sensitive to what your potential clients are looking for in a new practice.

Seize the opportunity to take a hard look at where your practice is and if you come up short, just give me a call and let’s figure out how to add an extra $200K to your bottom line this year.

When you “own it”, you have taken the first step in learning how to Summit.

Michael Abernathy, DDS
972-523-4660 cell
[email protected]