Are you losing patients?

Feb. 1, 2004
The place is San Francisco in October of 2003. The setting is the annual session of the ADA, a huge meeting with over 50,000 people from all over the world in attendance.

Annette Ashley Linder, BS, RDH

The place is San Francisco in October of 2003. The setting is the annual session of the ADA, a huge meeting with over 50,000 people from all over the world in attendance. I have been asked to lecture on the topic, "How To Get Patients To Say Yes to Periodontal Treatment."

Several doctors and staff members stayed after the program with comments on my remarks. One said, "Your ideas are great, but they won't work in our office." Another commented, "We have no room in the current schedule for recall patients, so how do you expect us to schedule time for perio? We just go ahead and do the best we can with scaling and root-planing when patients are here for a prophy, because we know we won't be able to give them an appointment later for the necessary perio treatment."

One scheduling coordinator said, "Your program would overwhelm our office! I couldn't possibly run that schedule; we have no room!"

The fact that this office was so busy and had "run out of space" in the hygiene schedule for current patients is sort of a good problem to have. It is certainly better than the opposite scenario, in which the hygiene schedule is not filled. What worried me, though, was that office had decided not to treat periodontal patients appropriately because of scheduling difficulties. That is a problem that carries serious risks and consequences with it.

I began to wonder how many more offices were turning potential patients (and production) away because of scheduling inefficiencies. Here are two ideas I hope will prompt you to:

1) Make sure that you know the scheduling status of hygiene in your office.

2) Think about where you are today and, more importantly, where you hope to be next year, in five years, or 10 years down the road.

We all agree that new patients are very important in sustaining a practice. However, patients of record — recall patients — form the heart of every dental practice. These are patients who know and trust you. They accept the dentistry you recommend and refer their colleagues and family to you ... and they've been doing that for some time. If you are faced with the problem of, "We don't have any room in the hygiene schedule," I hope it means you have grown your patient base over the years. Congratulations on your efforts! But is all that hard work paying off?

Answer the following questions to better understand what is happening in your hygiene/recall schedule.

• Can you accommodate the patients who come to your practice, or is needed treatment and the potential for additional profit being turned away?
• How well are you taking care of your core, active patient base? All active patients should have been seen during the past 18 to 24 months and received regular care (preventive and/or perio). We are not talking about the emergency patients from three years ago who never returned for a comprehensive examination.
• How many new patients are you seeing each month?
• How many hygiene days/hours do you need to treat your patient base? For example, one hygienist seeing 8-to-10 patients per day times 200 work days per year gives you the capability to see 1,500 to 1,600 annual patients through hygiene.
• What is the target-growth goal for hygiene?.Do you want to grow or perhaps redefine the practice?
• What percentage of periodontal services is generated as a result of hygiene production? The basic benchmark is 25 percent of hygiene serves as production for periodontal services and procedures codes 4341, 4342, 4355, 4381, and 4910. (Twenty–five percent is a conservative percentage when current research advises that 75 to 80 percent of adults have some form of periodontal disease.)
• What is your hygiene schedule effectiveness (hygiene schedule filled daily to 93 percent or better)?
• If you do not have enough hygiene days, what strategy should you explore? Should you add a hygienist or a hygiene assistant so that your hygienist can work with two treatment rooms? Should you extend your hours to accommodate patient volume? Should you consider bringing in another dentist?
• Is the practice growing? If so, why is it growing and what are you doing right?
•Is the practice shrinking? If that is the case, what created this problem and what do you need to fix?

Use this information to help you make informed decisions and begin some strategic planning.

Annette Ashley Linder, BS, RDH, is a recognized leader in the field and an award-winning speaker and consultant. Since 1989, she has presented more than 350 seminars and consulted in dental practices throughout the world. She is a featured speaker at dental meetings and provides in--office consulting services with her team of business and clinical consultants. She may be reached at her Web site at, via email at [email protected], or by phone at (804) 745-6015.

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