INCREASE YOUR PRODUCTION USING EXISTING PATIENTS.
There’s one simple truth about dentistry that can’t be refuted: the lifeblood of every practice is the patients—both new patients and recall patients.
Dental offices invest large amounts of money into marketing systems to attract new patients, but they should also invest time and effort into recall systems. While marketing is great for building a patient base and increasing the number of new patients, the purpose of adding new patients is to grow the practice with patients you see on a regular basis. If you don’t keep in touch with your existing patients and make sure they are making and keeping follow-up appointments, you will fail to retain them. It’s that simple. And when you lose patients, you lose productivity and revenue.
Times Have Changed
In my 30-plus years in the dental industry, I continue to stress the importance and necessity of having a productive recall system. In the past, when I asked clients to run the numbers in their databases to determine how many patients haven’t returned for recall appointments in the last six months, I always stressed that if they had one hundred or more patients on that list, then they have a poor recall system.
Today, times have changed, but not necessarily for the better. In the past few years, I have noticed an alarming trend among dental practices. I am no longer seeing six-month overdue recall lists (patients overdue by one day to six months) with one hundred names. Now I see lists with on the average of two hundred names and more!
If one hundred patients on a list seemed concerning, imagine seeing the lists doubling and almost tripling in size! Keep in mind that 200 to 250 is the average number of names on a six-month overdue recall list. I have witnessed dental practices with far more patients on their lists than the average! It is truly astounding and concerning.
Recalls Really Add Up
So why is having so many patients on such lists so alarming? Consider the following: an office runs a database search and finds two hundred patients in the past six months who should have come in for hygiene appointments but did not (either they cancelled the appointment, no-showed, or never made a return appointment). Regardless of the reason, two hundred people did not visit the practice.
Imagine that the office charges $200 for a hygiene appointment. A simple calculation reveals that the office lost $40,000 in the last six months, or about $6,600 per month. That’s a big number! And keep in mind, that’s merely the revenue lost on hygiene appointments.
On average, half of all adult patients need at least one crown. If half the number of those missed appointments (100 patients) need a crown (which averages about $900 per crown), you’ll discover that not only did the practice lose approximately $6,600 per month on hygiene exams, but the practice potentially lost an additional $15,000 per month in crown fees. That amounts to about $260,000 in lost revenue, annually. Yes, you read that right—$260,000!
Keep in mind, that figure includes only hygiene appointments and crowns. Imagine the additional dentistry that such patients potentially need: implants, full arch reconstructions, sleep dentistry cases, etc. With those considerations, the dollar figure just keeps climbing and climbing!
The numbers don’t lie. If you think you can afford to be carefree and laid back when it comes to the structure of your recall sys-tem, think again! You can’t.
Running Your Numbers
You might think, “This isn’t me! I have a great recall system!” Well, for your sake and the productivity of your office, I really hope you’re right! But there’s only one way to be certain. You have to run the six-month overdue lists.
Every practice management software system (Dentrix, Eaglesoft, etc.) includes a reporting system that runs lists for all kinds of recall patients: perio recall, hygiene recall, etc. If you don’t know how to run recall lists with the software program you use, check any materials you received when you purchased the program for instructions. Or check for additional resources on the manufacturer’s website.
For example, if you use Patterson Eaglesoft as your office reporting software, simply go to the manufacturer’s website (Patterson.eaglesoft.net) and click on the “Training and Support” tab. Once there, go to “Click here for FAQ” at the bottom of the page and you’ll be directed to a customer support web page (Pattersonsupport.custhelp.com). There you can search “recall lists” in the keyword field.
In this program, you can search between periods of dates (remember, I suggest always going back six months). Once you have chosen the dates to search, click on such criteria as, “Patients Due for Cleanings but No Scheduled Preventative Appointments,” or “Patients Not Seen Since Specified Dates,” etc. You can even narrow the query by selecting “Preferred Dentist,” or “Preferred Hygienist.”
Once you’ve made your selections, the program will run the requested report. It’s that easy. The verdict will be in and you’ll know the status of your recall system.
After you’ve run a six-month overdue report, check the following to determine your ranking:
Excellent = Anything close to 0
Concerning = Anything near 100
Detrimental = Anything over 100
After running the report, you’ll have a good idea of how much potential work you have available with recall patients. Just about every office can improve their recall system in some way, or in some cases, many ways!
Tips to Improve Your Recall System
In my Total Team Training seminar, I offer detailed methods for improving office recall systems. Here is a sample of the steps that I suggest to help you start making some initial improvements:
Step 1: Run the six-month overdue recall report. However, don’t think you can run this report only once. Your office should run this report every month! This report is absolutely crucial for an effective and efficient recall system. Up-to-date data will keep you current on patients who should have come in, but didn’t.
Step 2: Designate specific team members to start making calls and scheduling appointments. This may feel like an extremely daunting task, especially at the outset, when the number of contacts can potentially be very high. But don’t get discouraged. And don’t let your team members get discouraged. Ask them to make a specific number of calls each day, until everyone has been contacted. With daily effort, the numbers on the list will decrease and become a task that eventually only requires a few calls each day.
Step 3: Review your scheduling practices and leave time for additional appointments each week. You never want to book your schedule so tightly that you can’t accommodate new patients and recall patients. Unexpected events inevitably arise and can cause a patient to cancel or change a hygiene appointment. If you don’t leave space in the schedule for such modifications, a recall patient might fall through the cracks if he or she can’t reschedule in a timely fashion. Also, if you don’t have unallocated time in the schedule, how are you going to accommodate the patients who you’re calling in step two? Always leave some openings in the weekly schedule for recall appointments.
Automated Recall Systems
Clearly, improvements in technology can be utilized to benefit dental practices. We now have electronic databases to keep track of patients, where once we only had paper files. However, sometimes technology can turn into a crutch and actually impede success. Unfortunately, for some offices, the automated recall system may be such a crutch.
Automated systems send a text or email to patients to remind them about their upcoming recall appointments. While this might seem fantastic and a great way to save money on team members’ salaries, these systems don’t always deliver as imagined. The problem? Automated systems remove the relationship-building experience from the scenario—and building relationships through one-on-one interactions with your patients is a key component of a successful dental practice. Most patients just don’t have a com-mitment to an automated message.
Automated systems have been found to increase the number of cancellations and no-shows! Think about the havoc this could potentially wreak on your day. Most of these cancellations and no-shows are due to the fact that automated systems create an environment where the patient feels like a number. Patients no longer feel valued or important. The communication suddenly changes from a very personal nature to a highly impersonal one.
Some doctors report that younger patients prefer contact via text or email. To this response, I usually ask, “How is that working for you?” If the six-month overdue recall list isn’t around zero names, then dentists may want to consider whether the automated systems are truly getting the job done.
Whether intentional or not, more patients miss appointments from a computer-generated text or email than from appointments confirmed by a real person. There is less commitment with a text or email message because there is no relationship between the patient and the technology. The patient may feel that if you don’t have the time or interest to make an in-person phone call, then maybe he or she doesn’t have the time to come in!
I consulted with an office recently on this very topic. Here’s what they said to me: “We currently use [an automated system] to send our patient communication via text, email, and postcards. We make actual calls as well, but only if the patient doesn’t respond electronically. It seems to be great for some patients, but on the other hand, it makes cancellations much easier for patients. We are seeing more last minute cancellations and no shows.”
There is a place for automation and there is a place for human contact. When you’re dealing with patients, you need to treat them with true caring. They need to know that they’re just not a number in your practice. Patients should know that you value them enough to ask a human being to call and actually talk about setting up recall appointments. When you remove the human element from your practice by switching everything to automation, fewer patients may show up for recall appointments.
Making the Call
I’m a big advocate of using scripted dialogues when talking on the phone with patients. When team members practice and memorize these scripts, they know exactly what to say and how to respond to patients in any given scenario.
Memorized scripts work for one simple reason: they eliminate the need to craft a new message every time you talk with a patient. This allows the team member to focus on the patient and his or her needs. When you aren’t searching for the basic words to say about the purpose of the call, you can listen for cues that the patient gives with their responses (voice inflection, explanation of financial woes and personal problems, etc.).
Script memorization allows the team member to become an expert listener. The team member will know how to respond to pa-tients in a more effective way. And because of that, results from the calls will be more successful. I have found that with a memorized script, nine out of ten patients will agree to setup a recall appointment.
Not only is it important what we say, but it’s also very important how we say it. Team members should make sure their tone is both positive and appropriate. The goal is to communicate that he or she is happy to be talking with patients, concerned about their current situation, and resourceful in helping them solve any type of problem with rescheduling, etc.
Here is a sample dialogue to initiate a conversation with a patient who missed his or her last hygiene appointment:
(Team Member): “Hello, Lee! This is Amanda from XYZ Dental. We became concerned when we realized that you had missed your six-month cleaning and exam appointment. Our schedule is filling up quickly and I know how important this visit is to you. As a courtesy, I am giving you a call. Is a morning or an afternoon appointment better for you?
The scripted dialogue provides the team member with the information that he or she needs to schedule a recall appointment. Afterwards, the team member poses a question, and then waits for a response. Based on how the patient responds, the team member can continue the conversation appropriately with additional scripts.
For example, if the patient says that he or she can’t afford to come in right now, the team member will have a specific response. If the patient responds that he or she has been ill, then the team member will have a specific script for that circumstance.
Of course, all team member responses will be empathetic to the patient’s situation and will help him or her feel that XYZ Dental really does care. Even if the patient can’t commit to scheduling an appointment, the patient will know that he or she has chosen the right dental practice and when the situation changes, the patient will definitely come back in!
A Successful Call
I often hear from dental practices that they just don’t want to make these calls. Their reasons vary, but often they just don’t see the value. However, my goal is to help everyone understand how important these calls are to the success of your six-month overdue recall system.
I often think about a fairly recent experience with regards to this topic. I was consulting with a dental practice that was in desperate need of improving their recall system. I worked with the front office staff to run the reports and develop an action plan. As we looked over the list of patients to call, the team member assigned with making the calls wasn’t very excited. In fact, she wanted to cross one family off the list before the first attempt. She said, “We know they don’t have a lot of money. There’s no point in calling them. They won’t be able to come in.”
I was really disappointed with her attitude. In my professional and personal opinion, I don’t believe that dental professionals should make decisions for our patients. We need to give them all of the facts, all of the options, and then let the patients make the decisions about their own dental health! Don’t assume that someone can’t afford dental care. Give each patient the opportunity to have the best possible care and let him or her choose what they want to do!
After listening to the team member, I gently reminded her to call everyone. And I explained that she should have the same expectations for each patient—that they really want and need to come in! So she agreed to the task and started making the calls.
Later that day, the team member rushed up to me with a great deal of excitement. She said, “That family made an appointment! They were so happy we called. They thought we didn’t want to have them back as patients because we never called them back, so that’s why they didn’t return!”
With that one experience, that team member knew immediately the power of a phone call and the power of human contact in a successful recall system. And now—because I’ve shared this experience with you—so do you!
Always remember that diligent effort is required to improve your recall systems! Run your six-month overdue reports every month and keep making calls. Call each patient at least three times during the month to see if you can reach them. If you don’t reach the patient after three calls, then send him or her a note in the mail. It can be a letter or a card, but it needs to be a personal correspondence, with a handwritten signature. I also recommend that you place it in a sealed envelope—you don’t want the mailman reading your personal correspondence with the patient.
Personal correspondence is important because it sets you apart from the competition. The many offices that use automated recall systems correspond with their patients only via texts and emails. Set yourself apart from the competition and show your patients that your practice is a patient-focused one!
With consistent effort, you will be able to keep your recall lists current and cleaned up for the previous six months. Remember, your goal is to eventually have zero names generated when you run your six-month overdue recall report. That is the ideal scenario and one that you should always be working towards.
A good way to gauge the successfulness of your six-month overdue recall system is in the productivity of your hygienists. If they are sitting idly because patients aren’t showing up for appointments or because there aren’t enough appointments scheduled, then you need to work on your recall. Conversely, if your hygienists are constantly producing, but your recall numbers are still high, then perhaps it’s time to hire more hygienists so you can get the numbers on your report closer to zero. Remember, the best possible scenario and an indication of a successful recall system is that your hygienists are always productive with appointments and the number on your recall list is at or near zero.
A Thriving Practice
I truly believe that having an effective recall system is not just important, it’s urgent! Utilizing the patients you already have is the best way to improve overall productivity and increase the revenue of your practice. You spent time and money getting these patients into your office, now do what is necessary to retain them.
Keeping in touch with patients twice a year to schedule six-month hygiene appointments is a great opportunity for building per-sonal relationships. Patients will feel that you care about them and truly want the very best for them and their dental health. Interestingly, when patients feel this way, they are more inclined to recommend you to their family and friends. Ultimately, you will not only improve your recall system, you’ll also add to your new patient roster as well.
Patients are the lifeblood of every practice. Keep them flowing in—through both recall and new patient additions—and your practice will continue to develop and thrive!