Looking for new patients in all the wrong places

July 19, 2016
According to Henry Schein-surveyed dentists, the top concern of today's dentists is generating more new patients.

Jim Philhower

According to Henry Schein-surveyed dentists, the top concern of today's dentists is generating more new patients. This is because patient visits are down, as are the number of patients with private dental benefits.1 Meanwhile, patient acquisition costs continue to rise, both through external marketing and PPO participation.

We estimate there are 14 PPOs sold today for every one indemnity plan, with average PPO fees discounted between 20% and 40%. Despite high new-patient acquisition costs, very few offices track their patient retention rates and hygiene statistics. While a healthy patient replacement rate is important to offset the natural attrition that occurs, few practices have enough hygiene appointments to accommodate their current patient base if all their active patients were to follow their prescribed hygiene schedule.

Active Patient Count

The most important number to know in your practice is the active patient count. How many patients have been in your practice for at least one procedure in the last 18 months? Based on data from the thousands of practices we consult, the average active patient count is 1,500 for a solo general practitioner. The average office is open 1,500 hours per year. If your patients come in twice per year for a one-hour preventative prophylaxis, one hygienist could see 750 patients per year. Therefore, the average office would need two full-time hygienists to see 1,500 active patients. This calculation does not include scaling and root planing, nor does it include patients who need to be seen three or more times per year for therapeutic procedures. It also does not include new patients that the practice welcomes in annually. Yet, despite these numbers, offices still employ, on average, 1 to 1.5 hygienists.

Periodontal Procedures

According to the Centers for Disease Control and Prevention, nearly 50% of the population has a form of periodontal disease.2 Based on this statistic and knowledge of their patients' health, most dentists we consult believe 15% to 20% of their patient base should be in a soft-tissue program. Yet, when we measure our clients, we find the average practice has just 3% of its patient base active in its periodontal program. If the practice were to hit a target of 20%, it would need 1,200 hygiene appointments annually just to accommodate its therapeutic needs, assuming 300 patients visiting four times a year. In addition to improving patient health by ensuring they receive the care needed, therapeutic visits are also billed, on average, at 50% higher than usual, customary, and reasonable rates (UCR) than a preventive (prophy) procedure.

Reappointment Rate

How many of your patients leave your office with their next appointment scheduled? In reviewing our client data, we find many practices are between 50% and 70%. This leaves the office with openings in hygiene and costly labor time as team members make calls to "reactivate" patients. It is much more cost-effective to ensure your practice is appointing at least 80% of patients before they leave. Ideally, no patient should leave your practice without another appointment and completed financial arrangements.

Office Production Ratio

I recommend 30% to 35% of total office production should come from the hygiene department. If you commit to an increased focus on enrolling periodontal patients in a soft-tissue program, then 35% to 40% of the total practice production should come from the hygiene department. With this ratio, patients receive the care they need and the practice is more profitable, without using additional doctor time.

Assess your practice's metrics and opportunities, starting with your active patient count and hours of hygiene availability. Then, define your practice's standard of care for your periodontal patients and measure your current periodontal procedure counts. Most dentists find they need fewer patients and it is exponentially less expensive and more cost-effective to maximize their current patient bases and hygiene opportunities.

For help analyzing your practice opportunities and implementing protocols to increase hygiene appointments, request a Henry Schein Practice Analysis.


1. 2014 Income, Gross Billings and Expenses. American Dental Association website. http://www.ada.org/en/science-research/health-policy-institute/data-center/dental-practice. Published December 2015. Accessed February 15, 2016.

2. Periodontal Disease. Centers for Disease Control and Prevention website. http://www.cdc.gov/oralhealth/conditions/index.htm. Published March 10, 2015. Accessed June 9, 2016.

Jim Philhower, a 28-year veteran of the dental industry, is the director of North America dental sales leadership and development for Henry Schein Dental. He teaches dental teams around the world techniques to help them reach their practice goals. Contact him at (800) 372-4346 or [email protected]">href="mailto:[email protected]">[email protected]. Learn more at HenrySchein BusinessSolutions.com.

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