In a previous article, we focused on the concept of “forced change”. Something we could do that would cost almost nothing, but create a ripple effect on each team member, every system, and most importantly, improve the bottom line. It eliminates the question of where to start. It creates a tidal wave of change that washes away the poor habits and excuses most practice owners use to justify their poor results in order to elevate your practice to the next level. The prior article listed simple internal actions that will increase your direct referrals while making you look remarkable in the eyes of your current patients. At the same time, your team will notice your engagement in being more caring and compassionate. This should reinvigorate your culture, too. My challenge to you is go back and reread these strategies, but then immediately “act” on each of them. Don’t leave one out. Just act!
With the first example in mind, let’s take another look at areas that would allow you to use “forced change”. As we do this, please take note that each of these “forced change” actions will also create a culture of “staff ownership”. This staff ownership mentality is one of the three pillars of the Super General Dental Practice: www.supergeneralpractice.com for a free copy and read chapter 18 on the culture of a Purpose Driven, Doctor Led, Staff Owned practice. With each strategy, you should see a new awakening of this ownership mentality with each team member as well as a new commitment and engagement in your vision for the practice.
The challenge in a small consumer driven business (any dental practice), is that it is hard to stand out in a sea of average dentists. I’m confident that if we put 100 dentists in a room, not one potential patient could tell them apart. Literally, most dentists and their offices are almost invisible in the market place. Forced change has within it the power to remedy this and make you and your office look remarkable in the eyes of the consumer. The good thing about this is that the bar is set very low. It shouldn’t take much to look remarkable from the perspective of any patient. Forced change can actually make you look like a person wearing a red blazer when everyone else is wearing white. You should stand out easily. It should result in huge changes to your bottom line very quickly. These are can’t miss strategies. You just have to act!
Let’s look at forced change driven by demographics. Often times we read about some idea or strategy that worked great for someone who published an article in Dental Economics, but you wonder if it is really the right thing for you. Previously we talked about dozens of things that cost nothing and would work no matter where you practice. Let’s now look at a list of demographic data that could be garnered from www.zipwho.com by typing in your zip code and doing a basic search or doing a Google search for “list brokers” and asking for a little data. This data as well as the actions you should take will now be site specific for your exact location. Based on what you find there, there will dozens of black and white strategies that, if ignored, will destroy the growth in your practice. If you take heed and use this information to formulate forced change actions and act, they will catapult your practice to new record highs.
Income levels: Sadly, too many dentists “think like a dentist”. Basically, they don’t use common sense to make decisions about their practice. In respect to medium income levels in their zip code, 90% of dentists would gravitate or even argue that higher incomes are the best. Basically, a $150,000 a year income is a lot better than $50,000 a year. The patients will have more disposable income to spend on dentistry. They can afford what they want. I’ll be able to do a lot of cosmetic dentistry, or implants, etc. You get the idea. The problem is that it is exactly the wrong conclusion. People with high incomes mostly came from middle class families, went to college, many are professionals, all of them went to a dentist every six months of their lives, and if on the odd chance they had dental problems, they would have already gotten them fixed. In fact, comprehensive dentistry for this group is usually a cleaning and a bleaching tray. Bottom line: Higher incomes just mean they don’t need much dentistry. In fact, you would need to double the number of new patients in this demographic because while your hygiene department is busy, no one will really need to see you. But dentists who “think like a dentist”, almost always get this wrong. In fact, they get it wrong so many times that the high-income zip codes are also the ones with the most dental offices. With this in mind the best income levels will be about $45,000-$70,000. Keep in mind that they will have more dental need, but they also will have dental insurance and they will want to go to a dentist that is in their network. The take away here for forced change is to make sure you look at the income levels of your patients and then make changes to address their wants and needs. This must include how you handle dental insurance, how you stage the dentistry they need (phased over a period of time), the hours you work (lower incomes don’t or can’t come in from 8 to 5 on Monday through Thursday (you might need to change the hours you work), and the services you offer (orthodontics for adults like 6 Month Smiles, Clear Aligners, etc.). Other than adding the cost of learning some new services, these cost nothing and will speed change in your office by attracting more patients. Just another example of “give them more of what they want, and less of what they don’t want”.
Cost of living Index: Any level of income can be adversely affected by a high cost of living. One area of the country may have a cost-of-living index that is 400% higher than anywhere else in the US. This will kind of destroy your argument that a higher income means more money spent on dentistry. The trick here is that you need to assess the services you offer. Ask yourself: What would this demographic of age, income, race, education level, etc., want when they go to the dentist? Is there a service that would set you apart from the average dentist in your area? When would they want or need to come into the dental office? Find it, and use it against all of the average dentists in your draw area.
Where people work: Take as an example the zip code 75070. High top 10% income, but no one works in this zip code. They are young dual income families that drop the kids at school and then drive 20-30 minutes south to work. These people will never show up at your office if you are only open 8 to 5 Monday to Thursday. They have their dentistry done nearer to where they work than where they live. The forced change here would include being open all-day Friday and at least half the day Saturday. No more weekly hours than you work now, but better hours for your demographic. This will immediately result in an extra 20 new patients a month if you market the change while keeping your overall hours at about 32/week. Look at your competition and do something different than they do. Set yourself apart by proactively reassessing what and how you do business and quickly act to change any part of that to take advantage of some consumer driven trend or shortfall in other practices. Each of these demographic driven changes demand a “whatever it takes” mentality from you. Nothing is beyond the need to change. Again, this costs nothing and pays a wonderful return on your investment.
Percentage of owner-occupied homes: Owner occupied homes sometimes will give you an indication of the frequency needed to reach out to the public in your area. If the percentage of ownership is low, then the number of families renting would be high. People who rent tend to be more nomadic so this might indicate that the frequency of marketing would need to increase in order to reach them before they move. The folks who own homes tend to stay put longer and wouldn’t need the urgency of repeat marketing for that demographic. The mistake many doctors make is thinking that an apartment or renter wouldn’t need, want, or be able to afford a dentist. This is never true. Take the time to strategize to target these residents by increasing the frequency of reaching out to them monthly. Keep in mind a “new mover” strategy that drips 3-4 times on these new movers when they first arrive in your zip code. Get to them before someone else does.
Percentage of college graduates and professionals: The higher the income the less they will need higher end dentistry. The good thing is that they will be very consistent in keeping up with their cleanings and checkups. You should shoot for a benchmark of 85% recall or better. They will also want to bring their kids to the same place they go to the dentist. Too many offices fail to use children as a way to attract a large patient base. Large corporations learned that decades ago and that is why they have specialty services like endo, ortho, pedo, and oral surgery all in one location. If you want consistent year in year out growth, become that one-stop-shop for all their needs. The takeaway here is that Pedo and adult ortho fits this demographic and is easy to sell and very profitable.
Population in your zip code: The average zip code population in the US is about 25,000. If it is higher where you are or lower, adjust your expectations of how far someone will travel to see you. The average patient will not travel over 20 minutes to get to you. For most of us, that will be around 5-7 miles in any direction. In large cities, that could mean a mile or two. In West Texas that time and distance could easily double. Every dental software can give you the number of current patients in your office by age and zip code. Take a hard look and see how far away you draw in every direction and double down on your outreach to those areas that are currently feeding your office. Also look at any area within that 5–7-mile range where you are not getting your fair share of new patients and find out why. Offices rarely attract patients from an exact circle around their offices. Often there are artificial barriers that patients tend to not cross: rivers, large expressways, areas of lower income, high crime areas, heavy traffic areas, etc.
Median age: Every age has a certain profile of what they want, what they need, and where they shop. If the average age in your area is 35, you would also expect to see a large household number because they would have kids. If it is a retirement community, incomes may be tight and needs for dentistry high but their incomes may not have that monthly check they had when they worked full time. As you can see there can be a huge spread of needs, wants, and desires based on age in a dental practice. Set your hours and services to take advantage of those needs. Give them what they want, when they want it, at a price they can afford.
Race demographics: This can be all over the place but keep in mind that every patient you have is there for a reason. Older doctors tend to have older patients. From a race demographic standpoint, we want to be sensitive when we hire our team. Our team should reflect the race demographics of our location. In Texas, we need to have native Hispanic team members because about 12% of my population demographic is Hispanic. Whether it is white, Hispanic, black, or Asian, be sensitive to race needs and wants and make sure you take advantage of giving each what they might desire to pick you as their dentist. Looking remarkable to a potential client is influenced heavily by age and race.
Competition Demographics: I left this until last, but if location is the number one reason to open an office or not, then competition has to be the next most important benchmark. Don’t ever, ever, open an office where the ratio of dentists to population falls below 1:2,000. I would say that if you followed this advice, it would rule out almost every location in a city and a lot of suburbs. I rarely see an office recover from a poor competition demographic. It’s not that you can’t practice there. It is just likely that if you succeed it will take you two to three times longer and, for some, they will resign or settle themselves to just being another average dental office. I even see doctors turn their back on dentistry and just coast through their career because of a poor location choice. The tragedy is that they think that dentistry was the wrong profession for them when in reality, it was just a terrible place to open a practice. Better location always means better results, faster. Most doctors would have failed in these locations. One last thing about competition: Poor locations are extremely expensive to compete in. Too often, if you have been in dentistry more than 10 years, you may find you are now in the wrong location. Shift happens! Income levels, age, education, growth – everything changes and while where your location used to be great, there will always come a time when the demographic changes dictate that you move. Consistent growth can be destroyed by not assessing your location and adapting to a changing demographic and economy.
Let us also include a footnote about some specifics you need to be aware of in any location. Never pick a location where you cannot or do not have the ability to have great signage (LED, on the road with large monument signage). Always find a location where women go as a destination (Starbucks next door, large grocery store, dry cleaner, nail and/or hair salon, down the street from the elementary school, middle school, high school etc.). Never buy a practice or take a location in a professional building. This is an incredibly difficult location to overcome in a marketing sense. Normally you will need to spend about 3 to 5% of your collections on marketing. If you set up shop in a professional building, count on adding another $5,000 per month on marketing in addition to the 5%. Even that will not even up the odds of attracting patients compared to an ideal location.
With the exception of this last area in demographics, most of the forced change can come from doing things a little differently based on a thorough study of where you are and what the people outside of your practice look like. Don’t get set in your ways. Everything is changing. The worst thing you could do is keep doing what you are doing. What got you here will never take you to the next level of practice. If you want different results, you have to consistently change how and what you do.
Michael Abernathy DDS
972.523.4660 cell
[email protected]