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The art of patient retention begins with your practice is
structure. A few basic rules:
Hire pleasant, enthusiastic,
caring team members.
team members well, and appreciate them openly.
sure the office itself is attractive, modern, impeccably clean, in good repair including chair coverings in both reception and clinic
areas, has visible,
noteworthy signage---in short, a
place that feels and looks good.
Market your practice constantly and memorably,
making full use of social media as well as print media and community
top quality care to make you and your staff proud and patients delighted.
to sound fiscal management including an annual budget put into writing and into practice.
to show patients how much you and your staff care for each one as an individual, not simply a “crown prep in chair III.”
meaningful responsibilities to team members and then avoid micro- managing.
your vision of what your excellent practice will look and feel like, and then depend on your team to set the ambiance and culture of
the office so that each patient has an excellent
experience at every appointment.
Notice that the bare-bones list above begins and ends
focused on team members. Patients are
persuaded to remain in your practice by evidence of the genuine, unshakable,
enthusiastic commitment of your team, you included, to their care, comfort, and
long term health. One of your most
significant responsibilities as Team Leader is to convince every team member
that she/he is THE KEY to keeping
patients for life.
Make an honest evaluation here. Just between you and me…is your team lacking sincere
passion for patient service and real concern for patient retention? If the answer is “Yes.”, reproduce the piece
below, making a copy for each team member.
Discuss the concept in several team meetings, brainstorming ways each
person can enrich patients’ experiences in your office. Encourage team members to take this piece
home to re-read and to take to heart.
Arx a Kxy Pxrson
Xvxn though my computxr is an old modxl, it works vxry wxll---xxcxpt
for onx kxy. You would think that with
all thx othxr kxys functioning propxrly, onx kxy not working would hardly bx
noticed; but just onx kxy out of whack sxxms to ruin thx wholx xffort.
You may say to yoursxlf---“Wxll, I’m only
onx pxrson. No onx will noticx if I
don’t do my bxst. Patixnts won’t noticx if I’m cross as a bxar today.” But it doxs makx a diffxrxncx bxcausx to bx
xffxctivx, an organization nxxds activx participation by xvxry onx to the best
of his or hxr ability.
So thx nxxt timx you think you arx not
important to how our patixnts fxxl whxn thxy arx hxrx and how long thxy will
choosx to rxmain our patixnts, rxmxmbxr my old computxr. YOU are a kxy pxrson!
Several factors have worked together the past five to ten
years to create a perfect storm that has buffeted the dental profession: the economy has declined so that fewer
consumers are seeking regular dental care, participation in managed care has increased
thereby reducing practice income, and overhead has continued to require an
ever-greater percentage of gross income.
Such factors mean most dentists, no matter how much they would like to
do so, can no longer afford to give annual raises. Bonus plans have gained favor as an alternate
way to increase staff compensation so that the increase is fair for staff
members and the practice as well.
The plan described below is based on the premise that staff
compensation including wages, payroll taxes, and benefits is a set percentage
of gross collections. Note it is based
on collections, not production---the
office operates only on fees collected.
A survey of 2014 costs and profit by a dental practice
management company I respect and depend upon to have true current data shows
that staff compensation varied almost 10 percentage points--28.2% in General
Practice; 27.7% in Pediatric Dentistry; 25.5% in Periodontics; 21.9% in
orthodontics; 20.4% in Oral Surgery; and 19.2% in Orthodontics with no figures
available for Prosthodontics. For ease
of calculation, I’ll use 22% of collections allotted for staff compensation in
the following example.
$217,150 total collections ÷ 3 months
Staff Compensation compared to Collections:
$15,042/month staff compensation for
previous 3 months Average
collections/month for previous 3 months = $72,383
$15,924 = 22% of collections =
designated staff percentage
-15,042 = actual staff compensation
to be shared as monthly bonus
The incentive money may be divided among staff
based on the number of hours each works per month:
Dannie 154 hours
Heidi 138 hours
Laura 138 hours
Melanie 154 hours
total money to be shared = $1.32 per hour worked
670 total staff hours worked
Dannie 154 hours x $1.32 = $203.28
Heidi 138 hours x $1.32 = $182.16
Laura 138 hours x $1.32 = $182.16
Melani 154 hours x $1.32 = $203.28
Khloe 86 hours x
1.32 = $113.52
Include all staff members in the incentive plan; new
staff members may participate upon completion of their training period. Base calculations on collections, not
production. As production and
collections increase, keep the percentage allotted for staff compensation constant
until a new analysis of practice overhead percentages proves the percentage
should be changed. Pay bonuses with separate
checks, apart from regular paychecks, so that the extra pay stands out, seems
like a true bonus.
When to give
Increases to base salaries may be made periodically in
order to stay commensurate with similar jobs in your community. Since the bonus is a group reward for
increased-production-and-therefore-increased-collections, recognition of an
individual’s improved job performance
can be reflected through an increase in her/his base salary. If no raises at all are given to base
salaries year after year, staff members may feel unappreciated even if bonus
dollars have been paid monthly. Many
dentists now evaluate base salaries every two to three years, varying dates of
raises to individual staff members in order to avoid “blanket raises”. “Blanket raises” given to all staff members
at once seem automatic and, therefore, lose the value of expressing
appreciation to an individual team
member for a job well done.
Flying Doctors of America (FDA) is celebrating its 25th
anniversary this year. In its 25 year
history, FDA has completed over 220 missions and treated more than 200,000 people
in developing countries or in countries in crisis with free dental and medical
Earlier this year a group of dentists, physicians, and
nurses treated 1500 Syrian refugees in a refugee camp in Jordan. One participating dentist described the camp:
“Out in the desert, with brutally hot temperatures, are rows and rows of
tents. The devastation, the despair, the
look on children’s and adults’ faces---these people have been taken from their
homes and have been abused at all different levels. They have no place to go and nobody wants
He goes on to describe an 8 year old girl from whose face he
picked shrapnel. She was inexpressive,
non-communicative, and visibly traumatized.
She’d seen her parents and brother killed, a horror we cannot fathom. Years of service by this practitioner and
scores of others working through the FDA in countries around the globe has
taught these professionals that they must remember those they did treat, those they did save rather than ruminating over
the thousands they could not see and
Several flying dentists I have known acclaim the work of the
FDA. They feel privileged to help
provide health care for the poorest of the poor, disaster victims, and refugees
around the world. These professionals
serve with no thought of compensation or of politics. Their aim is to give in the best way they can
to fellow human beings who need their care.
To a person, upon returning home from a mission trip, these Flying
Dentists are already eagerly anticipating their next opportunity to help those
For information about Flying Doctors of America, visit their
The average dental student graduating in 2014 had $241,097
in student debt, and it was not unusual for students completing a residency
program to graduate with close to $600,000 loan debt according to figures
released by the ASDA (American Student Dental Association). What a burden these young dentists carry when
Corporate dentistry is growing rapidly with the four largest
dental management companies adding 902 practice locations in the past four years,
an 85% growth rate. With the offer of
immediate remuneration, these companies are attracting, according to some
experts, a majority of recent graduates
Dental management companies typically pay a producer 25% of
production, well under what an owner, partner, or associate in a busy private
practice would earn. In spite of such a
limit to their income, many recent dental school graduates are choosing to go
to work in corporate dentistry rather than in private practice or in
academia. Their choice is heavily
influenced by the over-whelming loan debt they carry which prevents their
securing another loan to buy into or buy out an established private practice. Further, most newly-minted dentists feel an
urgency to hit the ground running with a full patient load and no worries about
managing a practice---that sounds good after years of “round-the-clock, 24/7”
work getting through dental school and, perhaps, a residency program. Simply eager to begin treating patients,
these young dentists do not want to take time to research, negotiate, obtain
financing, and decide on a private practice opportunity. At that point in their careers, they do not
realize how such a choice may well limit their future earnings and their pride
in being an entrepreneurial health care provider.
Experts in dental practice management are emphasizing the
importance of educating dental students
more intensely about the advantages of private practice, such as much greater
lifetime earning power; independence to manage your practice as you choose,
including such seemingly-minor points as taking your vacation or C.E. days or
any time off when you wish rather than when the management company dictates you
may be away from the office; and ownership of a very valuable asset to be sold
Through repeated emphasis in lectures and classes on
practice management while in dental school and with mentoring by private
practitioners, young dentists can be persuaded to go into private practice vs
becoming an employee in a large corporation where they are simply a producer
with little to no say over their own career and life work. When hungry to begin practice, a new graduate
may give little thought to the negatives of working an entire career under a
corporation that is more interested in producing a profit for its stock holders
than in care for its patients. A
challenge facing the profession---those of you who love the practice of
dentistry in a private setting where the dentist manages her/his own destiny
should consider ways to educate and recruit more graduating dentists to follow
Today I drove a friend to work. She’s without a car, works at a family buffet
restaurant, often pulls double shifts, and depends on tips to make enough money
to pay her bills. She works very hard as
a server, has an always-positive attitude, and enjoys many regular customers
who request seating in her section of the large restaurant. Because she is friendly and fun, quick and
efficient, always smiling and showing genuine care for her customers, they
reward her with generous tips. Daily, in
fact, she averages over twice the amount in tips as her co-workers.
On the way to work this morning, she told me she often
receives a question from co-workers:
“How do you manage to get so much more in tips than I do?” She said she gives a candid answer to the
questioner---“Because I like my customers; I enjoy being nice to them; I tell
them I appreciate their coming to eat with me and their generosity with tips;
and I always invite them to come back to see me soon.” If the co-worker questions her further,
Jennifer will again be candid: “I’ve
seen you act like you think the customer is a bother; you act annoyed if a
customer asks for something; you don’t smile very much; and it seems you’d
rather be anyplace else but here serving a customer.”
Now---contrast the buffet restaurant employee’s attitude
which my friend described to attitudes among your own dental team members. Could the very direct, plain-spoken answer my
friend gave to her co-worker describe the attitude of any of your team
members? If so, perhaps sharing the
following quotation with your team will provide a springboard for discussion
among the group about proper appreciation of patients.
A patient is the most important
person ever in this office, either in person or otherwise.
A patient is not dependent on
us. We are dependent on her/him.
patient is NOT an interruption of our work, but the purpose of it.
are not doing the patient a favor by providing dental care; she/he is doing us
a favor by giving us the opportunity to do so.
patient is at the center of our practice; NOT on the outside.
patient is NOT someone to argue with---nobody ever won an argument with a
patient is a person who brings us her/his needs and values. It is our job to satisfy them with tender
loving care and to do so profitably to the patient and to ourselves.