Target marketing Choosing your patients before they choose you.

Sept. 1, 2001
During the last decade, dental practice-management literature bombarded us with a litany of marketing tidbits aimed at attracting new patients.

by Susan Smallegan Maples, DDS, MSBA

During the last decade, dental practice-management literature bombarded us with a litany of marketing tidbits aimed at attracting new patients. Many authors wanted us to believe that we were in vicious competition for a meager number of patients looking for a new dental office. Dentists attempted one technique after another to attract these prospects, and swerved in and out of success. Some even moved toward managed third-party plans that guaranteed warm bodies — at the expense of profitability.

Now the tide has turned. Predictions indicate a significant shortage of and high demand for dentists during this decade and beyond. Statistics support this view: We're seeing fewer dental schools, smaller class sizes, and a population of dentists — especially women — with fewer scheduled hours. Experts no longer predict that attracting new patients will be a primary concern.

This shift toward accommodating an increased demand for our services carries with it a whole new set of challenges. Although a surge of new patients lining up for visits sounds like a problem we'd all like to have, controlling this influx in a way that makes sense for the practice is more complicated than it appears. Instead of simply filling your chairs with anyone who needs an initial examination, wouldn't you rather select the patients with whom you really want to work? After more than 10 years of vying for warm bodies, hand-picking our patients could prove a welcome luxury.

The increasing demand for our services gives us real motivation to target our marketing to those patients we really want to serve. Very likely, these are the patients who are extremely loyal to the practice — patients who accept treatment, express gratitude while paying for services, commit to recommended recall, and refer their friends.

Within each practice one can identify "loyalists" as the patients who demonstrate these characteristics to one degree or another. Yet among the loyalists, only a select few enthusiastically recruit other patients. I refer to these patients as the "apostles." Customer research from Harvard Business Review (Jones and Sasser, Dec. 1995) suggests that on a scale of one to five, "apostles" are usually patients who rank their experience in your office right at the top (extremely satisfied). You would need a bulldozer to cart these patients away! Not surprisingly, "apostles" are among our favorite patients to serve.

The same research shows, however, that the difference in purchasing behavior looms large between customers who are extremely satisfied (a satisfaction rating of five), those who are moderately satisfied (a rating of four), or satisfied (a rating of three). In our practices, we serve a large group of loyalists who are moderately satisfied or satisfied. They prove their loyalty with repeated visits. However, these patients are at risk for changing practices. They can be lured away much more easily than we would ever imagine — by greater convenience, lower costs, advertisements, or incentives.

Many prominent and successful businesses have recognized the delicate relationship between satisfaction and loyalty. The following quote paints a vivid picture of this phenomenon:

"One discovery by Xerox shattered conventional wisdom: Its 'totally satisfied' customers were six times more likely to repurchase Xerox products over the next 18 months than its 'satisfied' customers. The implications were profound: Merely satisfying customers who have the freedom to make choices is not enough to keep them loyal. The only truly loyal customers are totally satisfied customers."

So the question remains: can you provide total satisfaction for each and every patient?

Of course not! If, however, you can confidently achieve that level of satisfaction among your "apostles," why not focus on building a practice around them? You can learn how to mold your practice to better serve the "apostles" and attract more patients just like them.

Before making your first move, however, beware of the possible pitfalls. Try this: With your team, identify your "apostles" by name. Begin describing them, focusing especially on their similarities. If you discover that your "apostles" are your biggest fans — but you are not theirs — you won't want to target more patients like them.

Either way, you will want to create an intentional strategy that sharply focuses on the patients you want to be your apostles — your "Dream Team of Apostles" (DTAs). Center your research on a specific group of five to eight patients who form your DTA.

Building a strategy
Strategic target marketing suggests that we develop a framework to attract more patients who match the DTA profile. The approach centers on three main tasks:

Create target market intimacy. Learn as much as possible about the similarities among your DTAs. Demographic attributes — such as age, sex, level of education, income, career choice, and home and work locations — prove particularly valuable. Developing a DTA demographic profile will lead you toward a more effective target-marketing strategy.

More important than demographics, however, are your DTAs' personal preferences, especially where they intersect with office experiences. One of the most effective approaches for discovering preferences is the DTA focus group. Invite each DTA patient to an informal gathering along with a few key staff members. If your DTA group has more than six individuals, you may want to divide them into two smaller focus groups to facilitate more discussion.

Design questions that will help you learn more about what they like and dislike about your office. For example, what music do they like for relaxation? What do they like to read? What would be their choice of décor for your reception room? What refreshments do they prefer? What are their favorite shopping spots, movies, and books?

Most importantly, gather positive and negative feedback about their experiences. Learn which dental services they perceive as a need, and those that are a desire.

You may also wish to include direct questions about marketing such as, "If you were to move to a new area, how would you go about selecting a new dentist?" You can compile all this information to build a vision of a practice that is increasingly irresistible to patients who fit your DTA profile.

Use the information from your DTAs to transform areas of your practice. Your goal is to create more frequent "wow" experiences that transcend your DTAs' expectations. This, of course, is where the real work lies. Tailoring a practice that can predictably create more total satisfaction experiences for your target market will be your most difficult —and rewarding — task.

Take one step at a time, and recognize that this process may take years. For some practices, the doctor may need to make a significant investment in advanced clinical education to develop skills that will better serve the target market. For others, you may need to remodel your office or even move to a different location to satisfy your DTAs and patients like them.

Attracting and selecting new patients is the final and easiest task. Remember that creating total-satisfaction experiences for these patients virtually guarantees word-of-mouth referrals. Your office focus group can help develop internal and external approaches that will attract more patients like your DTAs.

To selectively distinguish among potential patients, train one key staff member to interview them (perhaps on the telephone) and determine if they are a good fit. Prospective patients respond very positively to such an interview; they learn more about your office and become much more invested in their reserved appointment time.

Be patient and go forth
The extent of the transformation required to "wow" your target market will depend heavily on feedback. As your practice nets a larger and larger population of DTAs, you must continuously seek ways to improve their satisfaction ratings. You may also find additional research activities like personal interviews and surveys helpful.

Should you ever lose a DTA from your practice, take the time to complete a detailed exit interview; discover what experiences the patient found less than favorable. We often learn more from honest negative feedback than we do from a stream of positive sentiments.

A practice with a vision for the future is an exciting, spirited place to work. You will find building a vision around your best patients gratifying, because you can easily measure the results. As you attract more and more of the patients you desire, the quality of your practice will improve; so will your profitability. Ultimately, the result will be a practice that moves ever closer to total satisfaction, not just for your patients, but for you and your team.

Target marketing: A success story
Seven years ago, our practice averaged 88 new patients per month, half of which were adults. One- third of these were for emergency care; few ever became "loyalists." As we tried our best to accommodate all emergencies with same-day service, we found ourselves working at a frantic pace with an unpredictable schedule.

At the same time, our new-patient examinations for scheduled clients were lacking. Although these appointments began in the doctor's chair, we felt we could be delivering much more to these patients.

As a team, my staff and I agreed that our DTAs (Dream Team of Apostles) consisted of patients who had selected and completed significant dental reconstruction and have long-term health and stability as their ultimate goal. We invited our DTAs to a casual wine-and-cheese focus group meeting. We then interviewed these patients about how we might better serve them.

The feedback we gathered was invaluable; we used it to make several changes over the following three years. First, we built a library for private breaks during long treatment visits. We placed a professional massage chair in the library and trained our team in basic techniques for head, neck, and shoulder massage. We also expanded our CD library and customized the music selection for the patients. We also enhanced our amenities for freshening up.

In addition, we significantly improved our presentation of treatment options by including digital and intraoral photography, cosmetic imaging, mounted models, and diagnostic wax-ups. We also chose not to participate with insurance companies.

Seven years later, we see 10 new adult patients per month and an equal number of pediatric patients. Our new-patient coordinator interviews each potential patient before setting an appointment. The decision to set an appointment or refer individuals to another competent dentist results from clarifying their values for personal health and their expected outcome in our office. We almost always refer new-patient-emergencies to younger dentists who are building their practices.

Taking this a step further, we spend an additional 30 minutes just talking during the doctor-and-assistant intake interviews. There, we uncover more details about the patient's ultimate desires for health, beauty, and long-term functional stability.

We also include a brief discussion regarding their current ability to dedicate resources (appointment time and discretionary income) toward achieving those goals.

Before developing this approach, our complex treatment plans were met with rejection time and time again. Discriminate target marketing has made the difference. Now our practice is finally attracting our DTAs. Better treatment outcomes, enhanced patient compliance with our recommendations, and a tremendously fulfilled dental team all reflect the success of this approach.

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