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I’ve gotten four separate questions concerning “how practices last year were busy and scheduled and now there were lots of holes. What is wrong”? Could be a lot, could be just the season, but there are several places to look first.

  1. Not actually pre-booking patients in Hygiene. If I had any office’s hygienist(s) in front of me and asked if they pre-booked patients for their future appointments, almost 100% of them will say: “Absolutely”. They would definitely all say “over 90%.” So go to your office computer and take a look out say 4-5 months and tell me what you see. There will be two possible results. One, we look and low and behold the entire day is filled which is bad because there is no room for new patients. Secondly, we look and see that there are only 3 or 4 scheduled in any 8 hour day and those are booked either early or late. These peak demand times are the very hours that a new patient will insist on and boom, no place for a new patient. Your goal should be to pre-book 100% of these recall visits, but only fill 70% of any future day while guarding the peak demand times (7-9 AM, and 3-6 PM or later) for your new patients. So if we do book 100% of today’s patients in the future, but only fill 70% of any one column, where do the other 30% go? They go in another column, knowing that when this time comes around in 6 months, you will need to hire another hygienist. The average hygienist can only see 450-550 patients in a year if they see them two times, while still seeing new patients and doing some scaling and root planing. If they see them 3 times, even fewer can be seen. So if you have 30 NP a month, or about 360 a year, you should need to hire an additional hygienist every 1.5 to 2 years. If not, you have as many patients leaving your practice as are coming in. This is the number one symptom of a Donor practice.
  2. Not having consumer hours and/or multiple doctors for expanded hours. I practiced for over three decades in a small, growing town located about 30 miles north of Dallas, Texas. It literally went from a typical county seat in a farming environment to a bedroom community for high-income, young, college educated, middle-class, dual income families.
  3. Not offering the services that patients want. Only the patient gets to decide what they want and when they want it. The mistake would be thinking the patients want what you have to sell.
  4. Not coming across as caring and compassionate. Every staff member should be hired for people skills and self-motivation.   Everything else can be trained. You will never come across as caring and compassionate unless your staff and systems put the patient first, and it shows.
  5. Increased competition. Violate the 1 dentist for about 2,000 potential clients ratio and you will struggle your entire career. Location will be the top determinant of whether you are successful or not.
  6. Not budgeting for marketing correctly and consistently. It is not a “throw money against a wall to see what sticks” or a “one and done” strategy. If everything you do is marketing, it is show time all day, every day.
  7. People don’t like you. Your systems/protocols are precisely designed to give you the results you’re getting. If you don’t like the results, you must make changes. One sure indicator is your percentage of direct referrals from existing patients. It should be 50-60% of your total new patients.
  8. Not fitting treatment into the patient’s budget. This will require several outside lending sources, various finance options, and helping the patients to understand what their budgets will allow. It is OK if it takes years to complete a comprehensive treatment plan.
  9. Dropping the ball. The phantom patient “wants list” that we never get to see is killing our results with most patients. This is why staff synergy and great systems hinge on your ability to ferret out what the patients really want and need in order to stay with you for a lifetime.
  10. Wanting the dentistry more than the patient does. If you come across as wanting the dentistry more than the patient, you will have crossed a line that can never be taken back. Patients today are educated consumers. They know about insurance and the cost of doing dentistry. They have compared and contrasted various offices and options, and most of us come out wanting.
  11. A high cancelation or no-show rate. More than 8% cancelations and/or no shows are symptomatic of poor scheduling, poor financial arrangements, and a disregard of striving to give the patient what they want.
  12. Not addressing the patients concerns about money, time, fear, or a lack of trust for your office. Each member of the staff, including the doctor, must become sensitive to the desires and needs of every patient. It is that commitment to excellence defined by the patient’s wishes and needs that defines the Super General Dental practice.

Regardless of our success or challenges, it is time for each of us to look in the mirror and actually see where we fall short. Asking the right questions is the start of every solution. This is how you Summit.

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

PS — Hot off the computer: The new voice of dentistry and the Super General Dental Practice has launched with a number of topics for your use in growing and improving your practice and securing your future. Give it a listen and be sure to send us your questions and suggestions.

PSS — Don’t forget to sign up for BEST for Dentistry (Building Everyone’s Success Together): ( It’s free, and you can stick tens of thousands of dollars back in your pocket before the end of the year. Only someone who is clueless cannot see the brilliance of getting pricing for all of your services, supplies, equipment, financials, and accounting at the prices that, prior to BEST, only huge national dental corporations could get. Be one of the many dentists that have already joined to make BEST the largest company of its kind in the country to stand up for the independent practice of dentistry. Join us and stop sending your supply salesman’s kids to private schools.