Ep. 123: The Missing Ingredient in Patient Retention
We all know that focusing on retaining patients is crucial for long-term practice success, and we’ve already done episodes on reactivating patients and building up your hygiene dept—but there’s another important aspect that most dentists overlook. This week, Jeff reveals what it is and how to manage it successfully so you start seeing better retention and increased production.
Links:
Download the MGE Reactivation Program - https://www.mgeonline.com/mge-reactivation-program
Sample HIPAA release form - https://www.mgeonline.com/sample-hipaa-marketing-release-download
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Questions From This Episode
Why is marketing only aimed at new patients a major missed opportunity?
Because for most dentists, marketing has become a hammer fit for exactly one nail, getting new patients, while the same intensity is almost never applied to the patients already in the practice. A practice adding a steady 40 new patients a month for five years, even after normal attrition, can easily be sitting on close to 2,000 recoverable patients generating almost no organized outreach at all, a real gap in revenue, retention, and referrals.
Why does a patient sitting on the incomplete treatment list for years become a marketing failure, not just a sales failure?
The original decline might genuinely be situational, a bad time financially, a scheduling conflict, nothing more. But if that patient never hears from the practice again in any meaningful way, the reason they stay disconnected for years shifts from that original situation to a lack of ongoing communication. Consistent outreach, calls, texts, letters, keeps that relationship alive enough that the patient eventually comes back in for something, which reopens the door to the treatment they never completed.
What are the two core objectives of marketing to your existing patient base?
First, keeping patients active and retained in the practice, since regular visits catch problems early and directly support their long-term health, with revenue and referrals as a natural byproduct. Second, keeping patients genuinely aware of everything the practice actually offers, since patients routinely don't know about services a practice already provides, sometimes going elsewhere for something available right there the whole time.
What should actually go in a practice newsletter?
A short, genuinely helpful educational article, team and office news that makes patients feel like part of the practice, a spotlight on a specific service with a simple explanation and real before-and-after results, and some kind of offer, ideally a free consultation rather than a discounted cleaning, to give patients a reason to reach out. It should go out at least quarterly, in both print and email, since forwarding orders expire and email alone often gets buried or filtered.
Why should overdue patients get regular multi-channel outreach instead of occasional postcards or a single phone call?
Because most offices simply aren't structured for real follow-up, everyone is already occupied with immediate daily tasks, so overdue patients quietly drift further out with each passing month unless someone is specifically responsible for pursuing them. Patients still within their recall window need to be actively chased to get rescheduled, while genuinely overdue patients need consistent, repeated contact across calls, texts, emails, and mail, since a single missed attempt easily turns into years of silence otherwise.
Episode Transcript
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If I asked you why you're doing any marketing at all in your practice, most dentists would answer one of two ways: to get more new patients, or to increase collections. And if you dig into the second answer, at least 80 percent would say marketing helps collections specifically by generating more new patients. So for most of the dental industry, marketing has become a hammer fit for exactly one nail, new patient acquisition. If that's your only lens on marketing, you're genuinely missing out, on real gains in collections and profit, meaningful improvements in patient retention, and a more stable, steadily growing practice.
Beyond new patients, what other marketing should a practice be doing? Marketing to your existing patient base. Reaching potential new patients in your area is a vital part of any growth strategy, but marketing to the patients you already have deserves that exact same intensity and consistency. That's what I want to cover this week. My name is Jeff Blumberg, and I'm your host, and we're covering the basics of continuous marketing to your existing patient base, the why, the how, and a handful of specific ideas you can start using right away. This isn't an exhaustive list, just a solid starting point.
Let's start with a simple definition of marketing itself. In its simplest form, marketing is what a business does to promote and induce the buying or selling of a product or service. A lot of people think of marketing as simply making themselves known or building goodwill, but the real purpose is inducing an actual transaction. A TV commercial or a YouTube ad exists to get you to buy something, or to get a company to sell you something.
Plenty of things fall under the marketing umbrella beyond advertising itself, market research, sales support materials like brochures or educational content, even packaging. Think about the experience of unboxing an Apple product, that's technically marketing too. Or compare a luxury car dealership, a nice coffee machine, someone in a suit rather than a mechanic in a garage, versus a standard dealership. That's part of marketing as well, closely tied to customer service and the actual service delivered, and all three need to align. Fancy marketing paired with a disappointing in-person experience creates a real letdown, the same way a beautifully advertised restaurant with a rude host and inattentive staff falls flat even if the food itself is good.
Ultimately, marketing exists to make people want to buy something and to make that buying process easier, and with healthcare specifically, that need has to be genuine or, in the case of cosmetic services, at least genuinely wanted.
Where the dental industry as a whole tends to get shortsighted isn't really an individual failing, it's more of an inherited industry norm. Think about PPO participation: a dentist practicing 30 or 40 years ago would have been baffled at the idea of accepting 60 percent of a normal fee. But once 80 percent of the profession participates in some form, newer dentists entering the field simply assume that's how things have always worked. The same pattern shows up with patient retention, a genuine weak spot across the industry that's quietly become accepted as just the way things are.
Here's a concrete illustration. Say a practice adds 40 new patients a month, a solid but not unusual number, for five years straight. That's 480 new patients a year, 2,400 total over five years. Even after losing 20 percent to relocation, plan changes, or general attrition, that still leaves 1,920 patients, nearly 2,000, not even counting the 40 still coming in every single month.
If those roughly 2,000 patients were properly activated, educated, and retained, at two recall visits a year each, that's 4,000 recall visits annually. Spread across 50 working weeks, that's 80 recall visits a week, enough to fully occupy two full-time hygienists, and that's before counting periodontal maintenance or new patients also flowing through hygiene. In practice, you'll rarely find a practice with these underlying numbers actually hitting anywhere close to that 80-visit figure. Part of that gap is a sales and follow-up issue, but a real part of it is a genuine marketing failure too, since so much marketing energy in dentistry goes toward new patient acquisition and almost none toward communication and follow-up with patients already in the practice.
Your incomplete treatment list is a good place to look for proof of this. Not every decline is a failure of communication, sometimes it's genuinely situational, a patient in the middle of refinancing a home, say, who asks to wait and simply falls out of contact afterward. That initial decline might be a sales or follow-up issue. But if that same patient sits untouched on your incomplete treatment list for two full years with no meaningful outreach in between, that ongoing silence becomes a marketing failure. With consistent communication, calls, mailers, something keeping them genuinely connected to the practice, that patient very likely shows up for something eventually, even just a cleaning or whitening, which reopens the door to the treatment conversation that never finished.
What supports and reinforces marketing here is genuine follow-up, and most practices simply aren't built for it. Whether or not you have clearly divided roles, scheduling, finance, and so on, or everyone's lumped together as front desk, everyone already has a full plate of immediate daily tasks. Unless someone is specifically responsible for chasing inactive patients back onto the hygiene schedule, especially with 2,000 to 3,000 inactive patients on the books, that follow-up simply doesn't happen consistently.
Think about the asymmetry here. We know the average new patient from a postcard campaign costs around 350 dollars to acquire, and a mediocre Google pay-per-click campaign can run closer to 420 dollars per new patient. That's real money and real effort going into acquisition. But once that same patient is in the practice, whether they accepted full treatment, partial treatment, or just what insurance covered, very little ongoing effort goes toward keeping them engaged, even though continued treatment over their lifetime as a patient depends entirely on them staying in the practice.
Picture a 52 year old patient who cost 350 dollars to acquire via postcard, had a great experience, accepted a full treatment plan, and got scheduled for their next recall, say six months out. Six months is a long time, and life happens, a family emergency, a work trip, something unexpected comes up, and they call to cancel. Ideally the office reschedules them immediately. But say the front desk is slammed and simply notes it for follow-up instead. That's exactly where most practices fall short, since nobody is specifically tasked with pursuing that name persistently.
What actually happens in practice: maybe someone calls a week later about a last-minute opening, the patient's still busy, no reschedule happens, and then there's no further contact for another three to six months, maybe surfacing again only during an occasional chart audit. Compare that to the urgency around new patient acquisition, get them in within 24 to 48 hours, and the contrast is stark. The effort, time, and genuine attention put into retaining existing patients is often minimal to nonexistent.
This shows up clearly whenever a practice adds a new service. Say you've added implants, a new clear aligner system, or sleep apnea treatment since a patient's last visit. In most cases, the only marketing material generated comes from the company teaching that service, maybe a banner or a sign in the office, but direct outreach to existing patients about it is rare. I've heard from newer clients whose own patients went elsewhere for a service the practice already offered, clear aligners, for instance, simply because they never knew it was available in-house. Patients know far less about what you actually offer than you'd assume, and not everyone thinks to just ask.
This also shows up with patient membership or discount plans, subscription-style arrangements where a patient pays a flat monthly fee for free cleanings and a discount on other services. These plans typically fail not because they're poorly designed, but because nobody's actively selling them to patients. Front desk staff already juggling scheduling and daily demands have no real incentive to pitch it, since missing a hygiene opening tomorrow creates an immediate problem, while not mentioning a discount plan doesn't.
So marketing to your existing patient base really comes down to two core objectives. First, keeping your patient base active and retained. A patient who shows up regularly gets problems caught early, stays healthier, and enjoys a better quality of life as a direct result, revenue and referrals are simply a secondary, welcome byproduct of that health outcome.
Second, keeping your patient base genuinely aware of everything you offer, health-related services like implants or advanced restorative techniques, and cosmetic options like veneers or clear aligners too. Even something purely elective, like fixing a diastema with no health implications, matters to a patient who simply dislikes how it looks, if they know it's an option. Ideally, you'd even segment this further, tracking which patients are realistic candidates for specific services so outreach can be genuinely targeted rather than generic.
So what are some concrete starting points? The basics apply first: genuinely good customer service, a clean, well-kept office, quality dentistry delivered on time. You don't need an eleven-thousand-dollar imported countertop, a decent paint job and real cleanliness go a long way, you can always upgrade later.
On retention specifically, beyond the standard next-appointment scheduling and reminder text or postcard, a few additional things matter. First, patients still within their original recall window, meaning they haven't technically become overdue yet, deserve genuinely proactive pursuit from your scheduler or hygiene coordinator, actively chasing them to reschedule rather than letting them quietly drift toward becoming a fully inactive patient.
Truly overdue patients need a consistent, ongoing communication cadence, calls, texts, letters, emails. We have a Reactivation Program, currently being updated, with a structured sequence of outreach steps, available as a download on the episode page, along with sample letters. One client used a bulk texting service effectively here, alternating messaging month to month, sometimes a straightforward come in for a cleaning, other times offering a free consultation specifically for patients of record. That consultation offer in particular drove strong results, bringing back patients who'd been away for years because of an issue they'd been quietly dealing with, a bothersome tooth, something missing. A patient you haven't seen in three or four years still knows and trusts you far more than someone you're meeting cold off the street, which makes closing genuinely needed treatment considerably easier.
In-office promotion matters too. If your mission statement touches on helping patients maintain their oral health for life, and it should, reinforce that same message visually, small signage in the hygiene area about the importance of keeping recall appointments plants that idea before a scheduling conflict even comes up. The key across all of this is consistency, hitting patients across multiple channels, mail, email, phone, in-person conversation, on a regular, ongoing basis, not sporadically.
Retention marketing also extends to routine seasonal outreach, back-to-school reminders, insurance benefit reminders in October about year-end coverage, another reminder in January about renewed benefits. Even if you don't participate in insurance or accept assignment, these still function as a legitimate reason to invite patients back in for a consult or a cleaning. I'd send these via both mail and email, check your own inbox and you'll understand why relying on email alone is risky, spam filters and promotional tab sorting mean plenty of patients simply never see it.
Finally, a genuine practice newsletter serves both retention and awareness of your services. Posters and in-office signage matter here too, and I'd also recommend using your waiting room television intentionally. Skip the news, skip generic cable, and instead run a looping video mix of patient testimonials and short educational segments from the doctor personally, explaining a specific treatment, followed by a testimonial or two with real before-and-after results, cycling through on a one to two hour loop. You'll need proper releases for this, a sample HIPAA release is available on the episode page, though have your own attorney review it before use. These same videos are reusable across TikTok, YouTube, Facebook, or Instagram too.
Picture the actual effect: a patient sitting in your waiting room, not necessarily thinking about veneers, watches a short segment explaining what they are, then sees a genuine before-and-after result from an actual patient. That plants a seed, and often surfaces later as a direct question to the hygienist or the doctor.
As for the newsletter itself, I'd steer away from a generic, purchased template that clearly wasn't made by your own practice, an obviously homemade newsletter, even simple, a large sheet folded down into a basic mailer, tends to actually get read, since patients recognize it as genuinely coming from a business they know. Include a short, genuinely useful educational article, nothing lengthy, team and office news that makes patients feel like part of the practice, a spotlight on a specific service with real before-and-afters and a simple, approachable explanation, and some kind of offer, ideally a free consultation rather than a discounted cleaning, which risks devaluing routine care for existing patients. Vary the specific offer issue to issue. Send it out via both mail and email at minimum quarterly, mail matters here too, since postal forwarding orders expire after six months, and email alone risks getting lost in spam or promotional folders.
On introducing new services specifically, frame it around the patient rather than your own learning curve. Announcing you just learned to place implants can come across as a bit unsettling to a more cautious patient, whereas simply mentioning the practice now offers implants lands much better.
All of this, videos, posters, newsletters, seasonal outreach, targeted service awareness, should live on an actual marketing calendar with clear ownership, ideally the same person already managing new patient marketing. Done consistently, it stabilizes both retention and revenue, and a healthier, more active patient base naturally generates more referrals too.
So the message here isn't to ease up on new patient acquisition, if anything, stay just as aggressive there. But don't overlook the patients you already have, they're a genuine part of what makes your practice what it is, and they deserve real, ongoing attention too.
I hope this helps. Downloads for the Reactivation Program and the sample HIPAA release, have your attorney review it, are on the episode webpage. If you have questions about anything covered here, email me directly at jeffb@mgeonline.com. If you want to learn more about MGE, visit us online at mgeonline.com or call 800-640-1140. Have a great week, and I'll see you at the next episode.