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Patients Putting Off Care Means Lost Revenue


When patients put off needed care, it not only affects their oral health; it also affects your practice's bottom line. Here are some strategies to deal with the issue.

When patients put off going to the dentist and receiving the care they need, it becomes a matter of dollars and sense.

It makes no sense to avoid getting routine care that could prevent small problems from becoming larger ones. And it costs your dental practice in the form of lost revenue when those patients put off visits.

“Every person who comes into your office is going to spend some money, either through their insurance carrier or out of pocket,” says William Kohn, DDS, vice president,

dental science and policy for Delta Dental

. “And if it’s an insured person, most preventive and diagnostic services are paid at near 100%.”

So it pays to get reluctant patients into the practice.

Lost Revenue

Kohn points out that every patient who doesn’t make or keep an appointment is lost revenue for a dental practice—whether that revenue comes out of a patient’s pocket or from an insurance company. It’s also a lost opportunity for the patient to validate that he or she is in good health.

“It’s also an educational opportunity,” says Kohn of getting patients to make and keep appointments. “Minor problems that exist can be treated early.”

Kohn says the reasons why people avoid going to the dentist differs by age and by income group. Patients with higher incomes often feel that their mouth is healthy and they don’t need the care. But for patients in lower income brackets, cost is a driving factor.

“Getting around that is an educational process,” Kohn says. “We’re a preventive profession, and almost all dental problems can be prevented, primarily tooth decay and gum disease.”

But even with oral cancer, Kohn puts out, regular visits can help identify risk factors that can limit patient exposure to the disease.

“We have to sell that,” he says. “From an insurer’s standpoint and from a wellness standpoint, it’s all about educating people on risk factors.”

Prevalent Problem

The yardstick for measuring how frequently most people should visit the dentist is approximately one year, especially among those who are not at high risk. What determines high risk? Kohn says that if a patient has a prior history of fillings, studies indicate they’re more likely to have decay in the future, and therefore need more fillings.

“It’s not the best measure, but it’s the best one we currently have,” Kohn says.

Given that criteria, Kohn says approximately one-third of all people are at higher risk for disease. And of that one-third, about 70% receive oral hygiene exams each year. That means 30%, for whatever reason, are not coming in for care.

“That’s a significant number of people,” he explains. “And the big issues are cost, fear, and believing they don’t need the care.”

Edita Outericka, DDS, practice owner and dental director at

Dynamic Dental

, says part of the problem is a fundamental breakdown of patients’ perception of the importance of a healthy oral cavity.

“It seems to me that the dental office business model has taken the emphasis off patient education and placed it more on quick hygiene appointments,” Outericka says. “I have restructured my schedule to allow for more time in hygiene and during exams. This allows our practitioners to thoroughly educate the patients.”

Effective Strategies

So what can dentists do to help patients get the care they need, and generate added revenue at the same time? Email reminders? Postcards or phone calls? Kohn says he doesn’t know what the success rates are for either of those strategies, but believes most practices ask patients how they would like to be reminded.

“Then it becomes a team approach,” he says. “Everyone in the office is dedicated to the health of the people who visit and entrust their care to them. In a good office, everyone is trying to provide good education and a caring environment. And that’s what patients are looking for.”

Dental wellness, Kohn says, is an area of growing interest in the industry. Wellness has long been a big part of overall health, especially for large groups. More and more these large groups that have good wellness programs want to know what can be done on the dental side—because a clear relationship exists.

For example, the CDC reports that there are

more than 29 million people in the US with diabetes

. Another 86 million have pre-diabetes. Kohn says that dentists are increasingly aware of those statistics, and can make the appropriate referral to a physician if they suspect a patient has a problem.

“And that’s what wellness is all about,” Kohn says. “Identifying risk factors, then providing education and, oftentimes, incentives to visit the dentist and get the care patients need.”

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