Aging practice turns frail

Case Profile: Hilton Head ... office overlooking the 14th hole. Climate, deliciously sunny and warm ... truly a golfer`s dream. But don`t get envious just yet. This 31-year-old practice is growing frail, along with its transient, seasonal, retired patients. But that`s putting the golf cart before the course!

Sally McKenzie, CMC

Case Profile: Hilton Head ... office overlooking the 14th hole. Climate, deliciously sunny and warm ... truly a golfer`s dream. But don`t get envious just yet. This 31-year-old practice is growing frail, along with its transient, seasonal, retired patients. But that`s putting the golf cart before the course!

Symptoms: Despite the liquid assets that the doctor - we`ll refer to him as Mulligan - has been pouring into marketing and despite the three decades he`s been in practice, his active patient base is 429. Yes, you heard me right! And, no, he`s not semiretired. Looking to improve his shot, Dr. M called in the pros to get some advice.

Observations: Although patients are being lost to the same old problems of sick recall and pre-scheduling six months out, there`s a situation here with new patients that boggles the mind. Five and a half percent of annual revenues ($450,000) is being spent on a direct-mail marketing program consisting of a letter (flyer, actually) offering free exams and X-rays to new patients. This outlay of almost $25,000 a year for the last four years has netted the following: 32 new patients per month ... of which only six are being retained. Some score!

Discussion: On the golf course, the whole idea is to shoot low, but let`s leave that mind-set on the green. When new patients accept their freebies but don`t return, take a closer look ...

On arrival, the patient is greeted by "no one" because Dr. Mulligan has tried to implement (unsuccessfully) a "front-deskless" approach. (I`ll go into this matter in another issue.) An anonymous dental assistant dressed in scrubs gives the new patient a registration form to fill out. When that`s completed, the patient is brought back to the operatory where FMX and impressions are taken. The assistant charts existing conditions and sends the bewildered patient on her way! What a dental appointment ... she never even got to meet the doctor! On a subsequent visit (if there is one), the doctor does an exam and presents a treatment plan that typically falls into the $1,500-$4,500 range. "Hello, Mrs. Patient, now open wide ... wallet and mouth, in that order." What happened to rapport-building; to fostering confidence; to forging a partnership of prevention and treatment? Considering this approach, the question isn`t, "Why wouldn`t she come back?" It`s more like, "Why would she?"

Even though you`re introverted, Doctor, and this manner of handling patients falls within your comfort zone, think about this: Is Tiger Woods apt to move over and let his caddie take his shot?

Treatment Plan: Teeing off is no time to shoot in the dark. We, therefore, laid out a very specific model plan to be carried out for new patients. Seated in a consultation room, the new patient should be interviewed by a trained team member. The doctor then will come in, extend his hand, welcome the patient to the practice, and ask, "How can we be of help to you?" The hygienist cleans the patient`s teeth (if this is what the patient has requested), the doctor performs his exam and mentions a small problem which would involve no pain and only a small fee to treat at the next appointment. At that appointment, and not before, the treatment options are presented and discussed. In other words, give patients what they want, strive to educate them about the value of the dentistry you`re providing, and above all, take the time to build that all-important doctor/patient alliance.

Sally Says: Retentive patients are those who`ve bought into the premise that good dental health is the shared responsibility of a skilled, compassionate dentist and an educated, responsive patient. Do the educating, Doctor, and watch the patient respond.

Sally McKenzie is president and chief operating officer of Dental Partners, Inc., a full-service, in-office dental management and practice-acquisition company. She continues to serve as president of McKenzie Management, a division of Dental Partners, Inc. She can be reached at (800) 288-1877; e-mail dentalpartners@dpi-mckenzie.com; or visit her Web site at www.dpi-mckenzie.com.

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