Influencing patient retention in the dental practice

“I need more patients” is a statement I’ve heard often from dentists throughout my career.

While new patients are undeniably important to a practice’s success, practice owners should be aware of opportunities they may already have within their existing patient base. According to recent research, the average dental office in America has just a 65 percent patient retention (defined here as active patients seen in the last 18 months and with a future appointment scheduled). The dental practices that do the best with retention are aware of their number and are focused on maintaining or increasing it constantly.

Here are some ways to start influencing your patient retention.

Start with good data

Calculating current patient-retention metrics is the first (and maybe most annoying) issue practices have when addressing patient retention.

I have yet to work with a practice management software that makes this information easily accessible. Even if it is easy to quantify, is it accurate? For example, your practice may not be diligent about making patients inactive in the software or there may be patients in your system who are not actually patients, e.g., a responsible party entered into the system for insurance billing purposes who is not actually a patient of record. These two scenarios and many others will lead to a bad data pull and inaccurate metrics. Some practices will need to clean up their inactive-patient charts and data-entry processes before they are able to come up with an accurate number. Once you can reasonably determine your retention percentage, you can begin working to improve upon it.

Practice systems

If you decide you have a patient-retention problem, work to understand what your practice is doing (or not doing) that is leading to this issue. Answer these five questions:

  1. Does your practice have a check-out protocol?
    The protocol may be as simple as “every patient must stop by the front desk before leaving the office,” but make sure you have discussed proper verbiage and hand-offs to set your practice up for success. One question you should never ask is “Do you want to schedule your next appointment?” This allows for a “No” answer. Instead, be more direct and simply state “Let’s get your next appointment scheduled.” Or, work on alternative questions to start the scheduling discussion, such as “Do you prefer morning or afternoon appointments?” (CDA members can contact Lee Bentz for help establishing this protocol.)

  2. Who is responsible for scheduling next appointments and why?
    In my experience, the best person to schedule the next appointment is the hygienist. The hygienist is able to speak to the individual patient’s needs and therefore have a more productive and compelling conversation about their care. It is more powerful for your hygienist to say “I want to see you back in three months because I am concerned about the bleeding in your upper-right quadrant” than it is for a front-office team member to relay the same message. And when the clinician is telling the patient about their oral health condition and next steps, it is more convincing.

  3. Do you review if patients have their next appointments scheduled?
    In the practice I managed, we had “checks” in place to review appointments daily. For every patient who came in, regardless of appointment type, we checked to see if they had scheduled a next appointment. If a patient had not scheduled a next appointment, I would approach the team member(s) who assisted them to try to figure out why. If there were concerns or complaints, we would discuss them during our next morning huddle. Additionally, protocols should be in place for following up with the unscheduled patients. See the CDA Practice Support resource “Tips and Sample Letters to Manage Missed Appointments” (requires CDA login).

  4. Do you have appointment-confirmation processes in place?
    In present day, just about every patient is accustomed to receiving automated texts and emails, but what about the patients who don’t respond or those who do respond and miss their appointment anyway? Take steps to ensure these patients do not fall through the cracks. Ask your patients how they prefer to be contacted so you have the best chance of reaching them.

  5. Does your schedule offer appropriate patient access?
    If your practice is routinely unable to find any available hygiene appointments for more than six months out, it may be time to add a hygiene day. All dental plan provider agreements require patient access to routine patient care within a specified time frame. When measuring appointment availability for patients, bear in mind the dental plans’ access standards.

Office environment and patient experience

Ultimately, what patients experience when they visit your practice will determine whether they schedule an appointment to see you again. The most common reasons Americans avoid the dentist are cost and lack of insurance, but they also state that they dislike the lectures, the pain, the needle and drill and the sounds and smells. Some of these cannot be avoided, but items can be offered to patients to make them more comfortable. Headphones, sunglasses, pillows and TV or movies can go a long way to enhance an experience and make your practice stand out from others. Use the “Office Environment Evaluation” checklist (requires login) from CDA Practice Support to help ensure all areas of the office, from the hygiene rooms to the bathroom, offer the optimal experience for patients.

Find more articles on practice management in News & Events on CDA’s website. Find practice management resources, including those cited in this article, at cda.org/practicesupport.

This article was authored by Lee Bentz, practice analyst at CDA Practice Support, and originally appeared in the February CDA Update.

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