Keep your patients coming back

The issue of "lost patients" isn't just annoying; it can be costly. If you have been in practice for five years, you have probably lost more than a million dollars due to unscheduled dental work that needs to be done on existing patients, according to Joy Millis, C.S.P., a presenter at the California Dental Association (CDA) conference in April.

"A patient without an appointment is not a patient in your practice," explained Millis. As soon as a patient completes treatment, schedule a follow-up appointment. When recommending an appointment, use phrases like "Let's go ahead ..." rather than "Do you want to?" Send the message that follow-up care is a priority, Millis emphasized.

If patients leave without scheduling an appointment for recommended necessary care, make a note of why they are not scheduling. For example, patients can say they need to check their schedule or talk to their spouse. You should then call them within five to seven days after their last appointment to see if they have done so. If there is no follow-up, the patient believes the treatment is not a priority, time goes by, and the patient is lost.

When making an appointment, ask your patient, "If we have a change in the schedule and can see you sooner, may I give you a call?" This is an efficient way of filling holes in the schedule. When there is a cancellation, you can call any patient on the schedule and say, "I have good news. I promised to let you know if we had a change in the schedule and could see you sooner. We can see you today!" Millis said. It is better for patients to learn to come in sooner than to learn that canceling an appointment is perfectly fine.

If a patient does cancel an appointment -- even a three-hour crown and bridge procedure -- don't immediately deactivate them or label them as "bad patients." Patients have a life that has nothing to do with their teeth, Millis noted. Something urgent might have come up that made them cancel or miss their appointment. Many professionals make the mistake of thinking, "Why bother? If the patient wanted his dentistry done, he would be here." Meanwhile, boxes of charts representing lost patients continue to pile up in storage.

Rather than throwing up your hands in frustration, tackle those charts. "What if each member of your team contacted just one lost patient every day?" Millis asked. "What value could the team member return to the practice?" Dental insurance values a patient at $1000 per year. What are patients worth if they're lost?

Another Millis recommendation is to call patients for the right reasons. Don't call patients because the doctor told you to call or because there are holes in the schedule. "Call patients because you are concerned. Call because you care," Millis said. "Call for the right reason and you will get the right response."

It is also important to prevent buyer's remorse -- patients changing their mind about receiving care. Immediately after appointments with new patients, send a letter stating it was great to meet them and that you look forward to seeing them at their next appointment. Always act like patients are proceeding with the recommended care.

Millis also recommends not limiting patients to their insurance-covered care. In fact, the patient and the practice might be at risk when doing only this type of care, she noted. Patients don't always understand that dental insurance has limitations. They often believe their dental insurance covers everything.

"We lose patients every day because we tell them they have reached their maximum coverage and they believe they have to wait to have anything else done," Millis said. "If a patient needs treatment that is not covered by insurance, encourage them to make financial arrangements to receive care, and warn them about the possible dental loss that could occur if they do not proceed and that dental loss could lead to additional expense."

As it is, dental insurance does not cover a lot of treatment. "I see a patient walk into a practice with insurance, and I think to myself, 'Oh, you have insurance, which tooth do you almost want to fix?' " Millis told a laughing audience during her CDA presentation.

A patient who initiates care in your practice is your responsibility. In most states, you are responsible for a patient's continuing dental health for up to seven years after the first appointment. Patients should be warned about the possible loss they might experience should they not proceed with recommended necessary care -- whether they have insurance or not.

"When patients say they want to delay treatment, tell them their dental condition could get worse and more expensive. Then document your warning," Millis said. There are procedures for following up with patients who do not proceed with necessary dental care, along with procedures for ending your legal responsibility for them. Millis recommends that your state board of dentistry and attorney be contacted for ethical and legal advice regarding the termination of any relationship with patients.

The bottom line, Millis concluded, is to make every effort to bring patients back into your practice. "Do the right thing and you will never need to lose another patient again," she said.