Ep. 124: What’s the Best Appointment Length for New Patients?
It can be a delicate balance finding the right amount of time to schedule for new patient appointments. Too little time and you’re too rushed to form a good relationship and present their treatment plan properly. Too much time and it starts eating into more productive procedures. So this week, Jeff dives into new patient appointment lengths and how to maximize both case acceptance and efficiency.
Links:
New Patient Intake Form - https://www.mgeonline.com/np-intake-form
Phone Skills Course - https://ddssuccess.com/p/phone-skills-2-0
Listen to full episode :
Have a question for Jeff?
Fill out the form and he will get back to you.
Questions From This Episode
Should a new patient initial exam be scheduled for an hour or an hour and a half?
Both have a real place, and the right length depends on the specific patient, not a fixed office policy. A patient who's healthy, has no complaints, and needs nothing beyond a cleaning is well served by an hour. Someone whose intake answers suggest more extensive treatment is likely needed benefits from the extra 30 minutes, since that gives the doctor genuine time to present a treatment plan the same day instead of sending them home undiagnosed on a partial appointment.
Why is presenting treatment in the last 5 to 7 minutes of a one-hour appointment such a common mistake?
Because a genuinely large treatment plan simply can't be explained and closed properly in five to seven minutes, so the presentation gets rushed, the patient doesn't commit, and they land on the practice's incomplete treatment list, a list schedulers consistently describe as poor at actually generating rebooked appointments. Building real consultation time into the schedule, rather than trying to squeeze in a full presentation at the tail end of an already-booked hour, is what actually protects case acceptance.
How should reception decide which patients get the longer 90-minute slot?
By asking specific new patient intake questions rather than guessing, when their last visit was, whether prior recommended treatment was ever completed, whether they have any current discomfort, and whether there's anything they'd like to discuss with the doctor. Answers suggesting missing teeth, ongoing pain, or declined past treatment point toward the 90-minute slot, while a patient with no complaints and a clean recent history is a safe fit for the standard hour.
What's the actual downside of the 90-minute appointment, and how do you avoid it?
A no-show costs more time, since it affects both the doctor and the hygienist rather than just the hygienist, and if reception isn't well trained on the intake questions, patients who didn't actually need the longer slot end up eating 30 minutes of unused time on the doctor's schedule. The safer error, by comparison, is scheduling someone for an hour who turns out to need more, since the worst outcome there is simply bringing them back for a consult, not a wasted half hour that already happened.
What should a doctor do if a patient says they need to talk to their spouse before committing to treatment?
First confirm it's a genuine objection rather than a brush-off, if the patient clearly wants the treatment and it's truly just a matter of informing their spouse, that typically resolves on its own with a quick follow-up call. If the spouse's understanding of the fee, without the full context of the conversation, is the real sticking point, offering to walk the spouse through the treatment plan directly, in person or by video call, keeps the case alive and can even turn into a new patient if the spouse wasn't already one.
Episode Transcript
-
What's your procedure for scheduling a new patient initial exam? How long do you schedule for, an hour, an hour and a half, two hours? And who do they see first, the doctor or the hygienist? There's genuinely no industry standard here. I've asked rooms full of dentists these exact questions, and the answers are all over the place. Even two doctors who both schedule a 90 minute new patient initial might handle the rest of that appointment in completely different ways beyond the basic exam, X-rays, and probing.
So what's actually the best approach, and is there a way to structure new patient intake that genuinely supports practice growth, efficiency, case acceptance, and better customer service? That's what I want to get into this week, in a bit more detail than usual, walking through the real pros and cons of each approach and some guidelines to help you figure out what fits your own practice. My name is Jeff Blumberg, and I'm your host.
Quick disclaimer before I start: my background is in business, and I've worked with the dental industry for over 30 years, but I'm not a dentist, so I'm not in a position to weigh in on clinical judgment calls, diagnosis, or treatment decisions, that's entirely yours to make as the clinician. What I am sharing comes from what we've consistently seen work well across thousands of client practices from an operational standpoint.
Let's start simple. The most common length for a new patient initial, whether on the doctor's or hygiene's schedule, is one hour. The second most common is 90 minutes, and I've occasionally heard two or even two and a half hours, which is a lot of time, but if that genuinely works for your practice, that's your call to make.
I'm seeing more 90 minute slots lately than I used to. Interestingly, that extra 30 minutes has traditionally been used to fit in a prophy after the exam, charting, perio probing, and X-rays, just to avoid a rushed appointment. One thing that came up at a recent seminar, worth mentioning briefly: should you do a prophy on a new patient who turns out to have significant periodontal disease? Opinions varied quite a bit in the room, some worried about supervised neglect, others felt patients wanted to feel something was accomplished that visit. I'm not going to weigh in, that's a clinical call entirely yours to make.
Next simple question: should a new patient see the doctor or hygiene first? Also entirely up to you, no right answer, real pros and cons either way, and I've seen both work well. It's a personal preference, not a make-or-break decision.
Let's walk through the actual process to see where the real difference between one hour and 90 minutes shows up. First, intake itself, I won't get into phone conversion skills here specifically, we cover that in other episodes and in a full course on DDS Success, link on the episode page. But the single most important thing about new patient intake is being able to get people in quickly.
If someone calls saying they just moved to the area or are looking for a new dentist to get a cleaning, and you can't see them within 24 to 48 hours, that's a real red flag. If you don't already know how long it currently takes to get a new patient in, ask your office manager or scheduler directly. If the honest answer is four days or a week out, that's a genuine problem, especially if you're running any kind of marketing.
Think through the actual scenario: someone finds you through a Google ad, calls, and asks how soon they can come in. If the answer is ten days out, there's a real chance they hang up and call the next practice on their list instead, since there's no existing relationship pulling them toward waiting for you specifically. A referral might wait, someone with zero prior connection generally won't. If you can't accommodate new patients quickly, you're quietly working against your own marketing spend, and that's worth fixing immediately.
Once they're actually in the chair, the standard process happens regardless of appointment length, full mouth or panoramic imaging, perio probing, and at some point the doctor comes in for the exam and charting, and to actually meet the patient. Here's where it gets genuinely interesting, and where this connects directly to case acceptance, customer service, and practice growth.
The core problem with the one hour appointment: if the doctor comes in for roughly the last 20 minutes, spends 15 minutes on the exam, charting, and getting to know the patient, that leaves only 5 to 7 minutes to present a treatment plan, if the patient needs anything extensive. Trying to properly present and close a large treatment plan in 5 to 7 minutes simply doesn't work. A lot of doctors end up rushing through it, handing the patient off to a treatment coordinator, and the case doesn't close, landing instead on the incomplete treatment list.
I've asked clients, genuinely successful ones doing 2 to 5 million dollars a year, how large their incomplete treatment list actually is, and I'd encourage you to check your own. If you ask your scheduler how effective that list actually is at filling schedule openings, the honest answer is almost always not very. Occasionally a patient on that list will want to move forward when called, but far more often they're still thinking about it.
So the real fix is building in genuine time to close the case, which is really a sales conversation, not just a financial discussion, it's explaining clearly what someone actually needs. If you're 53 or 54 minutes into a one hour appointment and either the next patient is already waiting or this patient genuinely has to leave, you don't have time to present, and the right move is bringing them back for a consultation rather than rushing it.
What actually justifies a consultation? I'd reframe this from the old standard of only reserving it for something huge like a full mouth reconstruction or full arch case. Think of a consultation the way a business would, essentially a sales opportunity, a dedicated conversation to properly explain what someone needs and why. Even a 3,000 to 6,000 dollar case is a real financial decision for a lot of patients, potentially more than a full month's income depending on what they earn, and that genuinely deserves a real conversation, typically 20 to 30 minutes, not a rushed five.
If you can't present same day, bring the patient back, ideally first thing the next morning or first thing after lunch, when you can be genuinely distraction-free to explain findings and answer questions properly. If a patient asks why you can't just tell them today, it's fine to say you want to review their X-rays and case carefully to make sure you're recommending exactly the right approach for them specifically, and ask directly whether they can come back first thing the next available morning, confirming an actual time on the spot with your assistant.
The real risk with this approach is the patient not returning. That's the core tradeoff of the one hour appointment: it doesn't build in any real sales time at all. This is exactly why we've steered a lot of clients toward the 90 minute slot instead, baking presentation time directly into the same visit. If you're 53 minutes into a 90 minute appointment, you can simply transition straight into the consult room and present the treatment plan immediately, no return visit needed.
Functionally, the hour stays the same as a standard hygiene visit, the extra 30 minutes is purely dedicated presentation time on the doctor's schedule. That's the real advantage of 90 minutes over an hour.
But these two lengths genuinely suit different patients. Say a 23 year old calls in, healthy, no complaints, all their teeth, just wants a routine cleaning after relocating. That's a solid fit for the standard hour, there's a good chance nothing significant needs to be presented afterward, maybe a small filling at most, which is a quick conversation, not a real consultation.
Now say instead someone calls in missing three teeth, currently in some discomfort, and unhappy with a chipped front tooth. That patient likely needs more extensive treatment, and might be a better fit for the 90 minute slot. To use this approach well, you need a genuine sense, not a diagnosis, obviously, that's not reception's job, but a reasonable read on whether more extensive treatment is likely.
This means your intake process and whoever's handling these calls need to be genuinely sharp. If you're running something like an implant funnel specifically targeting patients with missing teeth, those calls are pretty clearly headed for the 90 minute slot. Otherwise, you're really just trying to get a general sense of whether real dental issues are likely present, enough to justify the doctor spending that extra half hour presenting a plan.
What you want to avoid is scheduling a healthy 23 year old for 90 minutes and having the doctor sitting with genuinely nothing to present after a quick, uneventful exam. That's dead time on the doctor's schedule that can't be recovered.
This is where your intake form matters. I have a sample new patient call-in form available as a download on the episode page, from our Phone Skills course on DDS Success. Beyond the basics, name, contact information, and how they heard about you, worth tracking closely for marketing purposes, I'd ask specifically: when was your last dental visit? Was any treatment recommended, and if so, did you go through with it?
If someone mentions being told they needed four crowns previously and never followed through, that's a real signal. You can also ask if there's a prior doctor to contact for recent X-rays if it's a second opinion situation. Then ask directly: do you have any discomfort or other dental concerns? Someone mentioning pain when chewing, or a dark spot on a back tooth that comes and goes, is telling you something meaningful.
Finally, ask: is there anything you'd like to discuss with the doctor, or that would help make your visit more comfortable? Someone mentioning they've always disliked their smile and are curious about clear aligners is giving you a real signal too, even if it's cosmetic rather than urgent.
Someone answering this way, missing teeth, ongoing pain, previously declined treatment, is a strong candidate for the 90 minute slot, likely moving straight from hygiene into a same-day presentation with the doctor. Someone answering no to everything, genuinely happy with their oral health, is a better fit for the standard hour. Either way, your receptionist or intake coordinator is making a real judgment call here, so they need to genuinely know what they're doing.
The good news: getting this slightly wrong in one direction is far less costly than the other. If someone who should have gotten 90 minutes ends up with an hour instead, the worst outcome is simply bringing them back for a consult, mildly inconvenient, not a real loss. But if someone who only needed an hour gets scheduled for 90 minutes, that's a genuine 30 minutes of the doctor's time sitting unused.
So, pros and cons. The 90 minute appointment's clear advantage is same-day presentation, more convenient for both the practice and the patient. The main downside is that a no-show costs more, since it affects the doctor's time as well as the hygienist's, not just the hygienist's as with a standard hour no-show. The other real risk is a missing decision-maker.
Say a patient goes through the full 90 minute process, gets a complete treatment plan presented, and says, this sounds great, but I need to talk to my wife first. If that's a genuine objection rather than a soft no, you've got a minor complication worth navigating carefully. Ask directly: is this something you want to do? If the answer is a clear yes and it's purely about informing their spouse as a courtesy, that typically resolves fine with a simple follow-up call the next day.
But if the patient seems genuinely uncertain how their spouse will react to the fee specifically, that's worth addressing more directly. Here's the issue: you've just spent 30 minutes walking this patient through a full, clear explanation of their treatment plan, and now you're expecting them to relay that same understanding secondhand at home. Realistically, the one thing that survives that retelling clearly is the dollar figure, not the clinical reasoning behind it.
Rather than asking the patient to call their spouse on the spot, which can put them in an awkward position, I'd offer instead: since your spouse wasn't part of this conversation, I want to make sure they understand why this matters just as clearly as you do. I'm happy to walk through the full treatment plan with them directly, whether in person or over a video call, whatever's easiest. That keeps the door open, and if the spouse isn't already a patient, it's a natural way to potentially gain a new one, while ensuring they're genuinely supportive of the decision rather than blindsided by the cost alone.
Beyond the higher no-show impact, the only other real risk with the 90 minute approach is scheduling patients into that slot who genuinely didn't need it, purely a training issue with whoever's handling intake.
As for the standard hour appointment, its advantage is simplicity, it's a well-established, easy approach, and an empty hour slot is simple to refill. Its main downside is that if extensive treatment does turn up, you're bringing the patient back, which occasionally means losing momentum, or in rare cases, the patient skipping that follow-up consult entirely.
I wanted to go a bit more granular on this specific topic since it comes up often and, done correctly, can genuinely benefit a practice. My honest take: there's a real place for both approaches in most practices, depending on new patient volume and how well-trained your intake process is, as long as each is actually used appropriately.
Shorter episode this week, I hope it helps. The sample new patient intake form is available as a download on the episode page, treat it as a starting template rather than something to use exactly as-is. The Phone Skills course on DDS Success is linked there too if you want to go deeper on training your team. If you have questions, email me directly at jeffb@mgeonline.com, find us online at mgeonline.com, or call 800-640-1140. Have a great week, and I'll see you at the next episode.