Ten years ago, while trying to put some thoughts down in my weekly blog, I decided to move toward a simplistic approach: A way to see your practice in black and white. Kind of a “you either are, or you are not” look at being on the road to success, or mired in the rut of mediocrity. I want to revisit portions of that article as well as well as revealing the symptoms of each. My contention is that you are either a “Donor practice” or a “Recipient practice”: Two opposites of the successful culture scale. The Donor practice is the office that just seems to drive patients away from their office, while the Recipient practice just seems to be the “It” office that ends up with the donor’s castaways. A good practice verses a poor practice.
Early in my career, I realized my best referral source wasn’t the direct response mailers, new resident programs, local newspaper, care-to-share programs, signage, or even our great 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: “Patients will bond to their dental practice for life”. In fact, Fortune magazine found that 87% of patients willingly change their Physician (MD) for a $5 difference in their co-pay 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’re gone. Patients today vote with their feet. If you are seeing the backs of their heads, you are doing something 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 you. The Donor practice has no idea that they have this effect on their patients. They are usually clueless. It is always the poor economy, or terrible location, or poor dental IQ, or inability to find quality staff that is blamed for lack of growth. I expect that all of my practices should grow regardless of the economy, and they do. The “Recipient practice” quietly grows, inspiring their patients to refer everyone they know.
What are the symptoms of a Donor practice? So glad you asked!
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 (lack of consumer friendliness) create such a hassle to get into your practice that patients make an appointment never intending to keep it.
Few or no Direct Referrals: (Goal is 60% minimally.) This is the one black or white symptom. Few referrals spell disaster. In fact, this is the number one KPI for any practice. The bad news is that few if any practices actually track this number.
Patients want second opinions: This is usually the result of an overly assertive rather than 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. Simply give them what they want and tell them what they need. Stop thinking that patients want what you have to sell them.
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. Spending money and time on marketing when you have few (or no) internal referrals spells disaster. You will just have more clients leaving faster and telling everyone they know to stay away. Don’t look for an external solution for an internal problem. Close your back door while opening the front.
Patients say they cannot afford your treatment plans: You must keep comparables comparable when it comes to fees. Stay in the 80-90% percentile fee range for your area. Always give the patient what they want first, then work towards giving them what they need as they continue to visit your office year after year after year. Bundling your fees and treatment plan incorrectly makes you look like a Dentist turned time-share salesman.
High staff turnover: Our office was fortunate to average over 14.5 years tenure for each employee. High turnover is a symptom of lack of leadership and poor 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, and they will be right. Everyone has worked in a bad environment and/or for a bad boss. They know the symptoms.
Assisted Hygiene. Assisted hygiene does help to ramp up the hygiene department numbers, 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 once created by your hygienist spending the time to adequately explain treatment and listen to what the patient came in for. I have seen few offices that do assisted hygiene successfully.
Invest the time to create great systems and inspire your patients and staff, and there is no limit to practice growth. This is how you Summit.
Michael Abernathy, DDS