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Openings in Your Schedule? Here's Why


The business side of dentistry can be a struggle to get a handle on for many practice owners, and when patients aren't flowing in, it can lead any dentist to self-doubt. What am I doing wrong? Why aren't my patients returning? Dr. Mike Abernathy, a veteran of dentistry, has a few pointers on how to fix your patient problems.

Openings in Your Schedule? Here's Why

What you want is not necessarily what the patient wants, according to Abernathy.

I received four separate questions in my emails reading something like this: How is it that my practice last year was busy and scheduled, and now there are lots of holes? What is wrong? Could be a number of factors, or it could be just the season, but there are several places to look first to find an answer.

1. Not actually pre-booking patients in hygiene. I would have to say that if I had any office’s hygienist in front of me when I asked if they pre-booked patients for their future appointments, I would have a 100 percent of them answer, Absolutely.” When I asked, they would all say more than 90 percent of their patients were pre-booked. So, go to your office computer and take a look at, say, four to five 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 three or four scheduled in an 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 percent of these recall visits, but only fill 70 percent of any future day while guarding the peak demand times (7 to 9 AM and after 5 PM) for your new patients. So, if we do book 100 percent of today’s patients in the future, but only fill 70 percent of any one column, where does the other 30 percent 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 three times, even fewer can be seen. So, if you have 30 new patients a month, or about 360 a year, you should need to hire an additional hygienist every 1 1/2 to two years. If not, you have as many patients leaving your practice as there 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 town that grew about 30 miles north of Dallas, Texas. It literally went from a county seat for farmers to a bedroom community for high-income, young, college-educated, middle class, dual-income families.

3. Not offering the services 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 have been hired for their people skills and self-motivation. Everything else can be taught. 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 one dentist for about 2,000 potential clients, and you will struggle your entire career. Location will be the top determinant of whether you are successful.

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. If you are not getting at least a 50 percent direct referral percentage from your existing clients, there is something they don’t like. Remember that you can’t get better at giving people something they don’t want.

8. Not fitting treatment into the patient’s budget. This will require several outside lending institutions, various finance options, and helping the patient 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’s 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 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. High cancellation or no-show rate. More than 8 percent. Cancelations and no-shows are symptoms of poor scheduling, poor financial arrangements and a disregard for what patients 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 be sensitive to the desires and needs of patients. It is that commitment to excellence defined by the patient’s wishes and needs that defines the Super General Dental Practice.

Regardless of your 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, is the author of The Super General Dental Practice.

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