Using the 80/20 rule

March 1, 2004
Pareto's Law (the 80/20 rule) has been effectively used for years by big business in marketing and sales. The 80/20 rule is a fascinating percentage which applies to so many areas of our lives...

Bill Blatchford, DDS

Pareto's Law (the 80/20 rule) has been effectively used for years by big business in marketing and sales. The 80/20 rule is a fascinating percentage which applies to so many areas of our lives, yet nobody can explain why it continues to occur. It really is the secret to success when trying to achieve more with less.

We coach our doctors and their staff members in sales to ask questions so that your guest — or patient — speaks 80 percent of the time. Conversely, if the staff and doctor are "educating" in 80 percent of their conversations with patients, they will talk their way out of a sale 80 percent of the time!

We receive 80 percent of our headaches, complaints, and cancellations from 20 percent of our patients. These are patients who don't see value in what we have to offer. We create "office policy" for all patients because of the problem few. As a result, the worst patients have helped us create a pessimistic practice, rather then one of optimism and trust.

A computer survey will show that 80 percent of your production comes from 20 percent of the patients. Look carefully at the top 20 percent of those patients in 2003. Who are they? What did they elect to purchase in your office? Why are they attracted to your practice? What can you learn from this exercise? Be curious and study this magic 20 percent. Focus and concentrate on replicating that behavior.

The 80/20 rule of marketplace consumption is in every industry. Airlines know they make 80 percent of their profit from 20 percent of fliers. These business travelers and frequent flyers are rewarded with extra perks, bigger seats, upgrades, and services. Airlines know they do not make their profits from a family traveling to Disneyland once a year.

Dentists tend to ignore the 80/20 rule because we are trying to please every patient all the time. Our percentages are reversed. We want patients to accept what we think they need. We work hard to reverse the thinking of the emergency patient who is demanding of our time once every three years. We struggle to diagnose above insurance maximums. Frustrated, we quit trying. We fill our hygiene schedule with any "meat in the seat." When patients cancel, we give them other immediate choices. We devalue our own work to cater to the 80 percent who are not our best patients.

In our coaching program, we designate patients as "A," "B," and "C." The majority of your patients are "A" patients who faithfully remember your birthday, bring tomatoes from their gardens to give you, keep their appointments, pay on time, and refer people just like them. Conversely, "C" patients are the unfaithful who have no tomatoes, only come in when it is convenient ... and who refer friends just like them! These are the 20 percent who create practice pain.

"B" patients just take up space. Their attention is sporadic. We want to have all "A" patients, but tend to create policies and treat people as if they were "C's." Watch for indications that you and your staff may be catering to the "B" and "C" patients:

1) Is insurance mentioned by you in the initial phone conversation?
2) Is the health history in the mail prior to the first appointment relationship opportunity?
3) Is money mentioned in the initial phone call?
4) Is respect for time a problem in your office?
5) Does a new patient sit alone in a "waiting room" completing forms?
6) Is one of your first questions, "Do you have any concerns today?"
7) Is finding insurance information a priority before the doctor sees a patient?
8) Are you insurance experts on codes, fee structures, and maximums?
If you answered yes to the above questions, you have geared your practice to the average patient. To cater to the top 20 percent, a clear sense of leadership and passion for change must be communicated and demonstrated. Stop doing the things that make you average and shift to being extraordinary. Attitude is a big factor. If you see yourself in the average 80 percent, unable to break out, stuck in a scheduling quagmire and an insurance diagnosis paralysis, you will stay in the 80 percent practice.

Find a coach who can turn that attitude into a winning one. As Lou Holtz says in a commercial, "Son, there is no such thing as just a sales call. You need a fight song!"

Dr. Bill Blatchford's Custom Coaching Program is now available anytime, anywhere. Utilizing 18 years of practice-management experience with more than 1,100 offices, Dr. Blatchford's custom program involves minimal travel and maximum personal time with the coach, interaction with other doctors, and tons of support. Leadership, systems, case-presentation skills, communication, and profitability are emphasized. He can be reached at (800) 578-9155 or visit his Web site at

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