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In desperate need: the Clergy Project

April 1, 2011
No doubt you've heard of paying it forward, the act of giving without expecting anything in return. The story of my "Clergy Project" began two decades ago. My initial intent was purely community outreach; however, the unintended consequence was a brand-new, long-term, measurable boost to my new patient flow.

By Dr. Tom Orent

For more on this topic, go to and search using the following key words: paying it forward, the Clergy Project, patient flow, expectations, Dr. Tom Orent.

No doubt you've heard of paying it forward, the act of giving without expecting anything in return. The story of my "Clergy Project" began two decades ago. My initial intent was purely community outreach; however, the unintended consequence was a brand-new, long-term, measurable boost to my new patient flow.

An uncomfortable question regarding need

Over the years I came across a number of patients who, upon first impression, seemed to have financial need. Note the key word here is seemed. How many times have you assumed that patients do not have the means to take the best care of themselves, and were shocked when they accepted, scheduled, and paid in cash for extensive treatment?

My first lesson in this came courtesy of a biker named Art. Art wore old tattered jeans long before old tattered jeans were fashionable. (Now, buying new old tattered jeans can be quite costly!) He had a long, gray, scraggly beard, a dingy old T-shirt, and a denim vest that matched his jeans – quite holey.

Certainly, at first glance one might assume that Art had little financial means, and that he might not be able to afford the extensive treatment that he desperately needed. You can guess the rest. Art not only accepted a complex comprehensive restorative plan (the very best dentistry I could offer) but he paid in cash. And the cash wasn't in his wallet.

Art routinely (as I learned later) carried an enormous roll of cash, thousands and thousands in hundred dollar bills. When it came time to pay for his care, he just pulled out the roll and peeled off an appropriate number of hundreds.

Two lessons I learned from Art

• Stop judging people by the way they look

Not only by the way they look … but by the car they drive, the way they speak, the type of job they have, and more. Bottom line is stop making judgments, period. We're simply wrong all too often. When you make this type of judgment, you tend not to offer the very best possible care. We hurt those we judge, and we hurt ourselves.

Many years later I was sitting at LAX airport, awaiting my red-eye flight to Boston close to midnight. I watched an elderly airport employee push a heavy maintenance cart down the hallway.

That night I had an epiphany about what people can and cannot afford. I shared the story with my team. Together we changed our paradigm to the realization that 95% of our patients CAN afford our very best long-term optimal care.

• Stop giving away what your patients truly can afford

It's a subtle difference, but it's critical if you are ever going to be able to maximize the profitability of your dental practice. It's a must learn lesson. In the first bullet, the concern is that when we prejudge people, we tend not to consistently or in an unbiased manner always offer the very best possible care.

Then there are the cases where we assume there's financial need, and we offer a patient a significant reduction in fee (or worse, entirely free) as an act of charity. Art is not alone. There are more patients than you can imagine who can easily afford your best care at your full fees, if they truly believe that there is an immediate and urgent need for that care.

Asking the uncomfortable. Enter the clergy

At least with long-term patients we may have some sense of their financial abilities, and they may be more inclined (due to existing relationships) to tell us if they've come upon hard times. The uncomfortable question arises when we assume new patients are in financial distress, but not from anything they have told us. The feeling is more from assumption.

One day I decided to be proactive about a situation and began to reach out to my community through the local clergy. I sat down and made a list of every church, synagogue, and mosque within five miles of my office. I had my staff research the names and phone numbers of the lead clergy at each location. Thus began my very first ClergyProject.xls spreadsheet.

As best I can recall, there were two or three dozen clergy on my list. I called them one by one. The calls were brief and incredibly well received. When you deploy your clergy project, you'll find that all are receptive with open arms, and many will be overwhelmed by your offer.

Just exactly what do you say?

Since it's far easier to start with a framework or guide created by someone else, I will share exactly what I said during those initial calls. It's really quite simple. Speak from the heart. Tell the truth. And quite frankly, have an offer nobody is likely to refuse.

"Hello, Father Johnson? This is Dr. Tom Orent. I'm your neighbor, a local dentist in Framingham. How are you, sir? The reason I'm calling is to share with you a dilemma I've come across and I'm hoping that we can help each other to solve. Every once in a while I run across a new patient who appears to be in financial need, yet may not actually say so. It's always difficult to know whether or not I should bring up the subject, and whether I should offer them charity care. Some folks might be hurt by the suggestion even though they may very well be in a tough place, whereas others may not actually be in need, in which case my offer is off base and inappropriate."

My staff and I thought about this long and hard and decided we should reach out to our community's clergy. After all, who better than the leaders of the churches would know who in their flock is truly in financial distress? Here's what I told them: that if one of their parishioners approached them with an emergency dental condition for which they could not pay, please call upon me.

Setting realistic expectations

I told the clergy that I wished I could take care of all the dental needs in their churches, but I'm a small family practice that doesn't have the resources for such charity care. But I told them what I could do. Any time one of their parishioners had a dental emergency, one or two teeth that I could resolve in one or two visits, there would be no charge. All they needed to do was reach out to my team and let them know the situation, and that they'd like to refer the patient to be treated as a courtesy.

Unexpected consequences and the bell curve

When I first began my Clergy Project I had one goal – to find a better way to identify those in our community who were truly in need and offer them free emergency dental care. Emergency was not limited to pain, but was more a broad brush based upon their perceived emergency need.

We saw people who couldn't go back to work due to broken front teeth. We saw people with pain, swelling, and more. We saw the whole gamut. The clergy always respected our limitations, and thus we were always able to deliver as much or more than the patient expected.

The feeling and feedback we received both from clergy and those we assisted was heartwarming. We knew we had come upon an effective means to identify those in true need, and to help them during tough times. But the unexpected consequences of our community outreach project were nothing short of stunning.

We began to receive referrals from those same clergy, referrals of entire families. The families were not in financial need.

These were families who had merely asked their preachers for a referral to a dentist they could trust. Over the months and years, our relationships with clergy in these religious communities blossomed. Referrals of paying patients became more frequent.

Of course, there is always a bell curve to everything. It's a math game. I kept track in the spreadsheet of those who sent emergencies and/or referred families. A few at the top of the curve became some of our best referrers.

Then there were those at the opposite end who were polite on the phone but never took advantage of our offer (and never referred). But the result was a win-win for all who participated. We continued to help those in need, and in turn, we often received their referrals.

Amazing experiences you cannot buy

As time passed, I was the benefactor of many invitations to participate in community events. One particular evening touched my heart and soul. I was invited to a Brazilian church by their pastor. We met as a result of my outreach project. The pastor asked me to join the congregation for a special New Year's Eve celebration.

There must have been close to 1,000 people in the church that night. There was a wonderful and festive atmosphere. It was electric.

Though I speak some Portuguese, my understanding is at about a first grade level. I didn't understand much of what the pastor said during the service.

All of a sudden he switched from Portuguese to English and said, "Ladies and gentlemen. I would like to acknowledge a special guest in our presence this evening."

I had absolutely no idea he was speaking about me! He turned toward me and asked me to stand and face those in attendance. "Friends, I would like you to meet Dr. Tom Orent. Dr. Orent is the dentist of our Brazilian community!"

All the money in the world could not have afforded the type of opportunity this pastor bestowed upon me that evening. I had helped members of their church with zero expectation of anything in return. We received more than expected with just the sincere appreciation of those we served. Yet, this pastor invited me to stand in front of his church so that he could declare me the "dentist of our Brazilian community!"


During my years in practice I became an avid student of direct response marketing. I was responsible for the creation and deployment of more dental advertising in my two practices than 99% of dentists would ever consider; however, a significant portion of my new patient flow resulted from various nonadvertising strategies and tactics such as my Clergy Project.

Gather your team and discuss putting together a similar community outreach via your local clergy. I guarantee you will all enjoy reaching out to those in need. Though it may not be your primary motivation, you too will find that you have built a network, a veritable army of the most credible and reliable referral sources anywhere.

Dr. Tom Orent, the "Gems Guy," is a founding member and past president of the New England Academy of Cosmetic Dentistry. His "1000 Gems Seminars™" span five countries and 48 states. Dr. Orent is the author of five books and hundreds of articles on practice management, TMJ, and Extreme Customer Service. To obtain FREE VIDEOS, including "How to Hire SuperStar Team Members" and "PROOF that 95% of Your Patients CAN AFFORD Your Very Best Care, Regardless Where You Practice, and DESPITE Our Trashed Economy!" and four free special market reports, go online to

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