Marketing clue — 20/60/20

June 1, 2008
You already have a group of patients you enjoy who are your fans, but have you ever really studied your patient fan base?

For more on this topic, go to and search using the following key words: fans, fan base, patient fan base, 80/20 rule, Pareto, marketing decisions.

You already have a group of patients you enjoy who are your fans, but have you ever really studied your patient fan base? Conversely, you have people scheduled for care who at the very mention of their names, your eyes roll and boots quake. Have you ever studied this group? Have you ever taken action on either end of the spectrum? By knowing intimately your own special 80/20 ratio, or 20/60/20 (explained below), you can make much better marketing decisions.

Other businesses in America know and use their 80/20 rule, which Pareto studied in the 16th century. Airlines and hotels know who is in their top 20% and airlines honor them with free miles, better amenities, upgrades, special offers, and priority luggage and seating. They know that 80% of their revenue comes from this top 20%. They need this group to be loyal to them. They have their eye on them, and they are high on their list.

The opposite end of the spectrum is the family of five who only travels for spring break every other year and wants the lowest fare possible where changes and refunds are not available. Their experience on the airline is very frustrating, food is minimal, and their luggage doesn't make it. The airline knows who these people are, offers no amenities, and encourages further trips only by use of the same airline more frequently, which adds to their revenue.

This study of your practice is such a valuable tool. We encourage our doctors to survey their patients and take action every year. It is more than knowledge. Action must be applied to create a better practice. With an Excel spreadsheet (some dental software programs will do this for you), find these patients and numbers. Note also who is insurance-based, find out how they entered your practice, who referred them, who they are referring, and what factors you feel allow them to continue in your fan club.

We find an elaboration of the basic 80/20 rule to be alive in dentistry — the 20/60/20 rule. We know that 20% of your patients create 80% of your profits. The next 60% of your practice produces another 30% of your profit. Whoa ... that's 110%. Hold the phone, because the bottom 20% of your patients actually create a loss of 10% of your revenue; thus we now total 100%.

We are urging action now when you know the configuration of your practice base. Action is necessary because this bottom 20% keeps you from being more productive, more creative, and more enthusiastic. Do you feel like you are destined to take care of people who don't see value in your work and, consequently, who show themselves poorly in your practice? Eighty percent of your problems, grief, and frustration come from the bottom 20%. If you are losing money on the bottom 20% of your patients, what do you think would be a prudent thing to do?

  • Quit appointing these patients in hygiene.
  • If they call for a hygiene appointment, ask for their credit card to hold the appointment.
  • Accept the fact this patient either has had the treatment he or she wants or won't be accepting your work.

As you carefully study the top 20% — your fan base — you will find the majority of 80% of your production comes from the top 10%. When you identify these patients by name, it becomes very clear that your priority needs to be with them. It is all about them. Create with your team a program of nurturing your top guests. Spend money and time acknowledging their interests, uniqueness, and strengths. What systems will you implement that will allow them to always think of you when outside conversations are about time, value, relationships, and focus? You want to be enthusiastically endorsed in these conversations. Knowing and analyzing your top 20% of clients will allow you to make confident marketing choices.

It may seem heartless not to encourage all of your patients to excellence. Think of it as a gift you are giving that bottom 20% in your practice. They will eventually find a place with similar values and systems, which will make them more comfortable. By allowing people to go, you create an environment for more top clients. You will be more focused, enthusiastic, and patient for these patients — the people who feed you and your family.

Dr. Bill Blatchford is a leading dental business coach who has worked with more than 2,000 offices to help dentists achieve more time off, more net, and more enjoyment. Become a member of Blatchford FILES, Dr. Blatchford's monthly CD on winning at dental business. The first two months are free. Call (541) 389-9088 or visit for more information.

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