April 1, 2004
Online and email surveys not only can enhance loyalty and increase profitability, but they also can provide valuable insight into patients' attitudes about dental care in general and your office in particular.

by Laurence I. Barsh, DMD

People are fascinated by surveys. Even a simple yes-or-no question can induce them to open a direct-mail envelope. A study by Paul Dholakia and Vicki Moritz published in the May 2002 Harvard Business Review concluded that simply asking customers their opinions can increase profitability over the long term. The authors' findings revealed that "conducting surveys, especially when customers are satisfied with the organization, can ... enhance loyalty and profitability." They further state that "A year after the survey was conducted [with a large U.S. financial services company], the customers ... surveyed were more than three times as likely to have opened new accounts, were less than half as likely to have defected, and were more profitable than customers who weren't surveyed."

Dholakia and Moritz felt this occurred because surveys fulfill the customers' desire to feel special; increase people's awareness of products and services; and, finally, induce people to form judgments that they otherwise would not have formed.

This study is particularly relevant to dentists today because it strongly suggests that online surveys can be used to improve practice profitability and ensure patient loyalty. Surveys should be an integral part of an effective marketing plan for practices that have an online presence.

When well written and administered correctly, surveys not only can enhance loyalty and increase profitability, but they also can provide valuable insight into patients' attitudes about dental care in general and your office in particular. Surveys can be targeted to your existing patient base and potential referrals from that base, or to a greater segment of the population, including patients of record, patients of another dentist, and people who may not be visiting a dentist at all.

Dental surveys have three functions:

To poll the needs and opinions of patients of record and people who may be interested in becoming your patients
To poll the needs and opinions of a random population of Web surfers
To introduce new services or market existing services

Examples of surveys could include:

Patient satisfaction surveys — This type of survey determines the satisfaction of existing patients with you, your staff, and your practice. It should be sent immediately after an appointment, which demonstrates your concern about patients and their perceptions of the services you provide. Patient satisfaction surveys also are an excellent way to gauge the satisfaction of a random group of patients with dental care in general.

Referral surveys — These surveys can be used to determine what a practice can do to increase referrals from patients of record. Author Frederick Reicheld, in his article, "The One Number You Need to Grow," (Harvard Business Review, December, 2003) documents how the majority of customer-satisfaction insight comes from the answer to a single question: Would you recommend this company to a friend?

Service based surveys — Of all the types of surveys that can be administered either on a public Web page or to a specifically targeted newsletter, service-based surveys are most suitable for direct marketing. Questions like, "Are you aware that the appearance of discolored teeth could be corrected in one short dental appointment?" or "Are you aware that our office is qualified to administer painless sedation dentistry?" not only help a practice understand what their patients' needs are, but also provides an opportunity to discuss what service a practice can offer to patients.

Before undertaking any survey, clarify its goals. You should have a clear, concise statement of what you are trying to find out with an online survey. Questions must be directly focused. To ensure high response rates and avoid misleading conclusions, surveys should be short, with questions that are well written and easy to answer. If questions are too complicated, or if the survey is too long, you will have a high dropout rate. Ask questions that address only your basic needs.

Prepare your target audience before sending an email survey or presenting it on a Web page. There should be an explanation about the goals and purpose of the survey, as well as one for why you want them to participate. You also should advise potential participants of how long the survey will take. In some cases, you want the survey to be passed on to friends and relatives who are not current patients. If this is the case, be sure to specify this fact in your email.

Although paper surveys and telephone surveys have been popular in the past, the trend recently has been toward self-administered online surveys. Online surveys have several distinct advantages. Respondents to an email survey tend to give more detailed responses to open-ended questions. The bulk of the responses also are returned more quickly.

Noted author and survey expert D.A. Dillman states, "There can be little doubt that the number of surveys being conducted over the World Wide Web is increasing dramatically. The ability to collect large amounts of data without interviewers, stationery, or postage, and to process answers without separate data entry, makes the cost of doing Web surveys very attractive."

Online response rates are much better than paper survey response rates. Online surveys usually average a response rate of 8 to 20 percent rather than the 1 to 3 percent with paper surveys. So how can you increase the response rate on your survey? According to the Beeliner i-collaboration (http://www.beeliner, there are several things you can do:

Prepare people to receive the survey — Statements in the newsletter or on the Web page that you are soliciting feedback and requesting assistance to improve your services and office policies can clear objections to taking a survey. It's not only common courtesy to let people know you need a few minutes of their time, but it actually can improve the response rate and the quality of the responses.

Offer incentives — Often even little incentive gifts can improve the response rate to a survey. The incentives need not be large. Offer to have a drawing among the participants; the prize can be a gift certificate or something similar.

Offer to share results — Very often participants are interested in the results of a survey. A question should be added to the bottom of the survey asking if they would like to see the results of the survey if you are willing and able to share.

Send surveys at the right time — The best days to send a survey are usually Tuesdays, Wednesdays or Thursdays. Mondays or days after a holiday are not good. Forget about sending on weekends. Most people receive the bulk of their emails early in the day, so the best time of day is usually between 10 a.m. and 4 p.m.

• Resend the survey one week later — People may accidentally delete your survey, their Spam filter may inadvertently remove it or perhaps people are bombarded with email on the day you send it. Sending it again may improve your chances of getting a response.

With these thoughts in mind, how does the average dental office go about conducting a survey online? Most of the survey software available was written for general business use and not for use in a dental practice. This leaves the dental practice in the situation of having to develop questions and administer surveys independently. However, some new software for conducting surveys has recently been written. Surveys conducted by Dental Economics have used a process developed by DENPAR ( The DENPAR system was designed exclusively for use by the dental industry to help dental practices:

• Acquire more patients
• Reduce cancellations
• Increase referrals
• Increase the services rendered to existing patients

This is accomplished with a program that systematically leverages a few specific technologies that are implemented for dental practices specifically. These technologies include a professional Web site, e-cards, online newsletters, and online surveys.The surveys can be customized for the practice or pre-created surveys can be utilized. The surveys are brief, never more than seven questions, and are used to help practices better understand their patients' buying habits, likes, dislikes, knowledge of their practice, referral habits, and more. Practices can send surveys after patient visits and/or on a recurring schedule. Even with a system like DENPAR, it is essential to develop and maintain a relevant email list (if surveys are sent out with email newsletters). This can be done by providing an opt-in link at the practice Web site. By asking a patient's permission to send email newsletters, you are essentially asking them for permission to be included in a survey. Naturally, each newsletter sent should have an easy-to-use "opt-out" method as well.


Internet use in the United States is growing at a rate of 2 million new users each month, according to a study by the U.S. Government. More than 143 million Americans (54 percent of the population) used the Internet in September, 2001. While the global power of the Internet is largely recognized, Respond Networks ( has found that many Americans use the Web to connect with local service-based businesses. Sixty percent of all online requests are for services. "... the Internet presents a great opportunity for smaller, regionalized businesses to market and sell their services" says Lyn Chitow Oakes, president of Respond.

With this explosive growth of Internet use, dental practices of the future will need to distinguish their practices online not only to serve the information needs of their patients and potential patients, but also to market their practices. Online surveys (conducted directly from a Web page aimed at the public or conducted from a link provided on an email newsletter to patients of record), when used in conjunction with an appropriately designed Web site and email newsletter, can be an extremely effective and professional way to market your practice.

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