Most practices focus all their energy on attracting new patients—but the real goldmine is the people already in your chairs. In this week’s episode, Jeff reveals proven strategies to keep patients active, complete more treatment, and generate more referrals from your current base.
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Questions From This Episode
Why should a dental practice market to its existing patients?
Jeff says a healthy general practice should earn at least 65 to 70% of its revenue from patients of record, yet most marketing targets new patients. Existing patients already have diagnosed needs, such as those on your incomplete treatment list, so marketing to them can make sales easier. He says this can double or triple volume, revenue, and referrals in an established practice.
How do you tell whether your practice has a retention problem?
Compare your total charts to the number with a next visit date. Jeff says an average office with 5,000 charts may have only 1,000 to 1,500 patients with a next visit scheduled. He says about 20% of patients chase you for appointments and about 60% need follow-up, so a practice that only follows up with the easy 20% loses the rest.
How often should you contact patients who have no next visit date?
Jeff says doctors at his seminars most often answer once a week, and he thinks that is reasonable. With 3,500 patients without a next visit, that is about 3,500 calls a week, or 700 a day over five days, so you may need to spread calls across the team or hire someone dedicated to reactivation. He also says no patient should leave without a next visit date.
What should a patient newsletter include?
Jeff recommends a homemade quarterly newsletter, mailed on a folded 11 by 17 sheet, rather than a canned one. It can include a short educational article, team and office news, highlights of services your patients need with before and afters, and a special offer such as a free consultation as a call to action.
How can you market specific services to patients already in your practice?
Pick the services you want to promote, such as implants, veneers, or clear aligners, and show the end result with tasteful posters and videos in the reception area. Jeff suggests repurposing the videos on your website and social media, and sending targeted emails or letters to patients whose treatment plans show they need a service. Staff should be able to answer patient questions about these procedures.
Episode Transcript
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How much marketing do you do to your existing patient base? If you're the average practice, little to none. The best it usually gets is maybe some back to school mailers, or "use it or lose it" letters toward the end of the year regarding dental insurance. Other than that, most marketing in a dental practice is targeted at new patients.
But here's the funny thing: a healthy general dental practice should be making at least 65 to 70% of its revenue from patients of record, from repeat business. So while new patients are important, and I don't want you to get the idea that they're not, or that you should not market for new patients as much, the fact that so much revenue should be coming from your existing base tells us that some effort, and by "some" I mean a lot of effort, should be going into marketing to your existing base. Why would you do this? How would you go about it? And what would happen to your practice if you did it right? That's what I want to talk about in this week's episode. My name is Jeff Blumberg and I'm your host.
I want to start by zeroing in on the purpose of marketing. Why are we marketing in the first place? There are a lot of quotes I could pull from influential people in the marketing space, but I think the most direct one comes from a man named Sergio Zyman. He used to be the chief marketing officer for Coca-Cola, and he's written a couple of books, one called The End of Marketing as We Know It. He comes straight out and says that the sole purpose of marketing is to sell more to more people more often. There is no other reason to do it. If you look at a lot of accomplished marketers, that thread flows through many of the quotes that are lifted from them. It should make sales easier. It should make sales almost irrelevant. It should be marketed so well. The idea is that marketing is supposed to sell stuff.
I'd challenge you to a thought experiment, and you can apply this to anything. I'll give you a couple of examples, and maybe they're not the best. When you buy something, whether it's a pair of sneakers, or you go to a particular restaurant, or you buy a particular car, what drove you to buy that? Maybe you saw it somewhere, maybe on social media. Maybe it fits a particular need. Let's take a silly example. Say I'm putting a new door up in my house and I need a hole saw that I'm going to attach to my drill. I know I've probably lost half the audience now, but bear with me. I need a hole that I can fit the doorknob through, so I need a hole saw. Am I buying a hole saw because I really want a hole saw? You didn't expect me to talk about hole saws on a dental podcast, did you? But here we go. No, I'm buying it so I can get a hole in my door.
Or if someone buys a purse, why are they buying a purse? There might be the label on the purse, but they're probably thinking, "This purse would look good with this. It'll make me look better. It'll fit with this outfit. It'll be great for this event." In other words, people buy these things not so much for the sake of having the thing. They're buying it for what it's going to get them. That's the whole idea. The same goes for why a patient would buy veneers. They want to look better. What's funny is that some people have a general idea of what a veneer is, but they really don't understand what they are. And you're not asking a dentist to place veneers so you can walk around and point to numbers seven and eight and say, "See, these teeth cost me $1,600." No, you want them to look so natural that nobody knows they're veneers. You want it to improve your overall look. You're buying it for the result, that you're going to look better. So when people buy something, they're buying it for what it's going to get them. Sometimes they need it, like you buy food because you need it, but you buy particular foods because of a certain product you're going for. It tastes good. Maybe it's good for your diet. Whatever.
So where does marketing come into play in all of this? Say I need to buy a tool. What's going to make me buy a particular tool, when there are a lot of different brands of that tool? Maybe I'm sold on a particular high-quality brand like Klein or Milwaukee or Wera. Or maybe I'm looking for a particular price point, or maybe the way it's displayed in the store influences my decision. The same goes for why somebody buys a purse. Maybe it's the name: Chanel or Dior or Louis Vuitton. It really depends on who's buying it. But ultimately the person is buying that thing based on some marketing that was done to them or for them. If I can have a celebrity carry a certain purse, especially a fancy celebrity, that notches up the value in people's minds. That is marketing.
Now let's go back to dental procedures for a second. We talked about why a person would get veneers, but what type of advertising is normally done for veneers? People generally don't even know what these are. They draw a bit of a blank if you ask them about veneers, how they work, how big they are, or how they're placed on a tooth. Most offices don't advertise them at all, but you have people in your patient base who actually need them. The funny thing about dental marketing, especially to patients of record, is that nothing is actually marketing it. It's basically just explained. A patient comes into your practice with some problems, and you tell them, "You're going to need two onlays and this and that." They say, "What's an onlay?" and you explain it. Maybe you have some pictures, maybe some before and afters. But that's the extent of dental marketing. It's done case by case, where you're explaining something to somebody.
To Zyman's point, marketing is about moving people to buy. Once you start seeing how it works on you, any type of marketing, and this is a thought experiment you can do for yourself, look at the things you buy. What made you buy that? How did you become aware of it? What made you decide it was the thing for you? You start to get an idea of how marketing works. And on top of that, look at the items you buy repetitively. Maybe you only buy a certain kind of sneakers, or a certain type of jeans or athleisure. What moved you in that direction? Maybe you enjoyed the product, which is obviously important, but before you could enjoy the product, you had to be made aware of it. How were you made aware?
Bringing it back to dentistry, how would you market to your patient base, and why would you? Obviously, if you're a general practice, firstly you'd want to keep them active so that you see them regularly and you don't lose them. If you've been listening to the podcast for a while, you know that this is a huge problem in dentistry, the drop-off rate in the number of active patients a practice ends up with. But I would add an additional tier to this. Beyond just keeping people active, I would want to target marketing to specific patients that would actually help sell more of the services they need.
And here's the kicker. Say I'm doing an implant funnel. I'm not saying you shouldn't do these, you should. I'm casting out a big net and hoping people who need implants respond, go through all the hoops, and answer all the questions, so that I end up with qualified prospects who need implants. But if a patient responds to your funnel, do you know that they need implants? You have an idea. Do you know that you can help them? Not necessarily until you've met them. That's with a new patient. With a patient of record, you've already diagnosed the treatment. You at least have a diagnosis that you made at some point in time. There's a valid need that's already established with these patients of record. Look at your incomplete treatment list. These are all people who need to be marketed to and sold, and if the marketing is good, sales become that much easier.
How would we go about doing this? I'm going to lay it out in stages. We'll start with the bare minimum and work our way up from there. My basic point is that if you have an established practice, this can easily double or triple your volume, revenue, and referrals. Why would it triple your referrals? The patients who tend to refer the most patients to you are patients who are satisfied with the treatment you've done. If you can get people back and actually complete these treatment plans, you're going to get more referrals. In the end, everybody wins. The patient is healthier, your practice is healthier, you're happy, you have more career satisfaction, and so on.
Again, we're marketing to our patient base to, A, keep them active, and, B, target them with specific services. The first stage is to keep the patient base active and retained, coming in on a regular basis, even if our overall marketing is anemic. If we have a volume of patients coming in regularly and not falling through the cracks, we can at least talk to them about what's going on with their dental health. How would we increase our retention? We start with the basics: good customer service, and an office that is clean and attractive. I always recommend, if you want to know how your office looks, walk outside for a second and walk back in. You have to change your viewpoint a little and pretend you've never been there. Or have a friend who doesn't come to your office regularly walk in and see things you aren't seeing when you go into the same environment day in and day out. You tend to get numb to things. You might have folders sitting on your desk for six months that you don't notice anymore. They become part of the furniture, whereas someone who hasn't been in your practice will notice a stack of folders on your desk faster than you will. If you can do this on your own, great. If you can't, have a friend come in and do it.
If we target retention, we start with some simple math. I've done numerous episodes on this, but let's start here. Take a look at your software and see how many patient charts you have in total. Say I have 5,000 charts. Then look at how many people, starting tomorrow, have a next visit date. Any software will tell you this when you open it up. If you're the average office and you have 5,000 charts, the number of people with a next visit date is going to be 1,000, maybe 1,500. You may say, "No, Jeff, there's no way." Trust me. You may be an anomaly, maybe 4,000 have a next visit date, but I would bet you don't. I could go off on this into a whole other episode, and I've done whole other episodes on it, but this is part of the flaw in the dental business model. There's a lot of attention paid to getting in new patients, which you should do, and you should not relax the attention you're paying. But there's very little attention paid to keeping people active in the practice, because we don't have the mechanisms in place to actually keep people active. I'll keep this brief if you've heard it before, but if you haven't, it's important.
Look at the amount of effort you put into getting a new patient into your practice. You spent money on advertising, or however you got that person attracted to your practice. You might be doing an implant funnel, Google pay-per-click, Facebook, postcards, whatever. The person responds, and the person who answers the phone, your front desk, has to be sharp in the way they handle the inquiry, get the person on the schedule, and get the person to show up. We put a lot of effort into this. New patients are really, really important, and I agree. Then that patient comes in, we do our exam and our treatment presentation, and they accept or don't accept the treatment. Say they accept. You do the treatment they need, or maybe part of it, and you schedule them for their next checkup, which might be three, four, or six months from now.
That's the mechanism, our recall area or hygiene department, that keeps people active within the practice, which is a great mechanism. No other business really has this. I'm sure there's something similar out there, but I'm not aware of any business, off the top of my head, with a built-in requirement to show up at least twice a year. Most businesses would kill for that. I'd love it if people had to come to MGE twice a year. That'd be great, easy for my business. I'd see people all the time, before they have big problems. I wouldn't have to wait until they have a catastrophic issue because I haven't seen them in two years. You have that built-in mechanism in your business.
Now this is where it starts to go wrong. The amount of effort, manpower, and man-hours spent on keeping these people coming back is usually anemic. It's low. It's not very good. A person misses their three or four month recall for whatever reason. They were out of town, or had a conflict, and then you don't schedule them for their next visit, or you tell them you'll call them back later. Before you know it, three, four, or five more months have passed, because nobody in the office has the job of chasing down people who don't have their next hygiene visit scheduled. It's no one's job. Usually people do it when they have time. If the office is busy, you're not going to have time. When the office is not busy, everybody gets on the phone and you get these people back. But this goes on long enough that eventually it's a year, two years, three years since the patient has been in, and then, for some reason, and I have no idea how this developed in the industry, it's one of the dumbest things I've ever seen, we decide that because it's been two years, the patient is no longer active and doesn't want to come back. We purge the chart. We stop calling them, which is extremely silly. You spend all this time and effort getting the new patient, when everybody's on the ball and performing at 100%. Then once they're a patient of record, it's almost like we forget all about them.
I'll tell you the secret, the simplicity to all this. Some people are very easy to deal with. About 20% of your base is very easy to deal with. These are the patients who, if you cancel their hygiene appointment because it was a snow day and you don't reschedule, will chase you to get the next visit down. These are your top-tier patients, but it's only about 20% of your patient base. The next 60% are varying degrees of more difficult, but they're good people. (The other 20% probably shouldn't be in your practice, which we've talked about before.) The next 60% are a little more difficult. They need follow-up. They're not as compliant, which doesn't make them deficient or defective or wrong. That's just how some people are. They're nice enough people, they just need reminders and calls, and they forget. Life gets busy. If you're only allocating time for that 20% of the practice, which is easy, you're going to end up keeping only 20% of your practice and losing the other 80%. You have to make time for this. This is why, when you look at total charts against how many have a next visit, you start to say, oh my gosh, you're losing quite a few of these people.
So what do we do to immediately increase our retention, beyond good customer service and making the office look great? We want to stay in continuous communication with our patient base. This can be done in a number of ways: texts, calls, emails, letters, bulk texts, and so on. You might even split it up within the office by function. Say we started with the example of 5,000 charts, and 1,500 have a next visit date. That's 3,500 people who don't. Some haven't been in for a year, some for six months, some for five years. We're probably going to have some people in the office, maybe even the dental assistants and the hygienist, everybody, spend a little bit of time every week calling some of these patients, maybe an hour or two a week. Then we have our schedule coordinator, who can spend a little more time on this. And if you have a treatment coordinator, you can split it up. I would have them focus on patients who are overdue for cleanings, not scheduled, and have outstanding treatment. They get them back on the hygiene schedule and start the whole sales process all over again.
To back that up, I'm going to have my reactivation letters, and I'll put a free copy of our reactivation program, which has a series of four letters you can send to patients to get them back, as a free download on the episode webpage. You can also use texts and emails. You could send a letter as an email as well, so I send somebody a letter as well as an email to make sure they get it somehow. I could also text them the same thing. It's continuous communication. I want these people getting contacted regularly so I can actually keep them active. Part of the problem is that you have a bit of a backlog right now. If you have 5,000 charts and only 1,500 have a next visit date, that means 3,500 people don't have a next visit date.
You may drop into apathy a little here as I talk about this, but if you have 3,500 people without a next visit date, how often do you think we should contact them to try to get them to schedule? If I ask a room full of doctors at a seminar how often we should call these patients, the most common answer I get is at least once a week. Some people say once a day, and I don't think that's very realistic. Once a month is maybe too infrequent. Once a week, I think, is reasonable. If you call them once a week, some people will say, "I'm not coming back." Some will say, "I moved to another country, or another state, and I won't be coming back." Some will say, "Oh my gosh, yeah, I have to schedule." Some will say, "Don't call me anymore." You'll get varying degrees of responses, and some people you'll just leave voicemails for and never get hold of.
If you have 3,500 people with no next visit date and you want them called once per week, that's 3,500 calls per week. If you're open five days a week, that's 700 calls per day. With salespeople, which is not what I'd be dealing with in your practice, a salesperson can make maybe 100 calls a day if they're decent. You're probably going to make fewer, and it's not so much the number of calls as the number of people you're having talk to patients right now. That's assuming my texts and emails may also be getting people to call in and come off the list themselves, hopefully. But that's not going to get most of them. It's going to get maybe my lower 20%, my low-hanging fruit, so to speak, the easy ones. Most of the people are going to have to be called. So this is where you have to confront, to a degree, that you might even have to hire somebody whose whole job is this all day. Maybe even a couple of somebodies, if this is a bigger problem in your practice.
The bottom line is that I want to make sure these people are getting regular communication. And to stop the hemorrhaging in the practice, I'm going to make sure, A, that a patient never leaves without a next visit date. That's just a no-no. And, B, I'm going to want to promote within the practice the fact that people should be coming in for regular checkups. We don't promote that. We promote sleep apnea, we promote Invisalign, we promote other things, but we don't promote that you should be showing up regularly for your checkups. I'd promote that very heavily. Even as the dentist, when you come in and do the exam, say, "Don't forget to make your next appointment. It's important that we see you again in three months." Make it a big deal, and you might have people show up more frequently. That's the first thing I would do: get that sorted out so people are showing up regularly.
Then, of course, I would do the standard letters, back to school, use it or lose it, and so on, and I'd send them out to the entire patient base, via email and most likely snail mail. And I would send out, at least quarterly, some form of practice newsletter. You can buy these canned newsletters, but I'm not a huge fan. I prefer the ones that look a little more homemade, because I think they're more apt to be opened. To keep this simple, get a big 11 by 17 sheet of paper folded to mailing size, folded in half and then in half again. What would be in there? Each newsletter could have a simple educational article, a short helpful tip, tips on dental health, new types of treatments, how to brush your kids' teeth, or whatever. You'd have any team or office news: office improvements, new team members, a new doctor, team milestones, like "Sarah has been with us for 10 years." I'd have something that highlights particular services, either new services I'm delivering or services that a large portion of my patient base needs. If a lot of patients need implants, I'd have material on implants in there, and I'd make sure I'm focusing on the end product, with before and afters and things like that people can see. Then I'd have some form of special offer at the end of the newsletter, a free consultation or a discounted something, because you want what we call a call to action in marketing.
Some people have a bit of a hang-up about this, not so much as they used to. I remember talking to doctors about advertising back in the nineties, and I'd say you need some kind of call to action, a discounted cleaning or a discounted exam, and they'd say, "I don't want to do that." And I'd say, you're going to send a postcard out saying "Get healthy teeth and gums for life, cavities and gum disease are bad, thank you very much, here's my phone number." There's no reason for them to call. You want to give them a reason to call, whatever that might be that you're comfortable with.
So if you had regular communication going to your patient base by text, email, snail mail, and so on, and at least a quarterly newsletter hitting your patient base, and you did this consistently, you would see a bump. But we really haven't, quote unquote, marketed to our base yet, and by marketing I mean pushing particular services. We've done a little in the newsletter, but how could we notch this up a bit? There are four or five things we're going to do. The first is to pick specific services that we want to market. Depending on what you do, it might be implants, crowns, veneers, inlays, onlays, clear aligners, maybe full mouth rehab cases or All-on-X cases, whatever it might be. We're going to market those within the office. This is where we want posters and signage that focus on the end result. Companies like Invisalign will send you these marketing materials, and the same goes for companies that make sleep apnea appliances. But there's no reason you can't make similar materials for the things you already do in the practice, whether it's an inlay, onlay, veneer, full mouth rehab, or whatever. You would advertise in the office. You can have posters in the various operatories or in the front, and they can be very tasteful.
You should also film videos on these, explaining what they are, with before and after pictures. Make sure you get the proper releases from the patients if you're going to feature before and after pictures in any of this. For example, we have a client who, when he sells an implant case, makes educational videos about implants that the patient watches before he actually presents the case. They're not boring and dry. They're very simple, so the patient understands a little about what the doctor is going to talk to them about. That's marketing. If you're making videos explaining these things, everybody has a TV in their reception area, and that TV might be playing Casey videos, or Animal Planet, or sometimes it's just a screensaver, which I've seen. It should be playing promotional videos as well as patient testimonials in your reception area. Just keep it low. You might have a video explaining what a root canal is, or what an implant is, or what an All-on-X case is, or what clear aligners are, playing in your reception area, interspersed with patient testimonial videos with before and afters. It can be subtitled so people can see it, and you don't have to have it blasting through the office.
What's beautiful about this is that if you have these videos going in your reception area, this video content can be repurposed a billion different ways, and that's a lot easier today than you think. Say you make a bunch of videos on procedures, very simple. You could put those on your website, on specific pages detailing those procedures. (This isn't patient of record marketing, by the way, this is new patient marketing, but you can use it for that.) You could put it on your YouTube channel, your Instagram, or your Facebook page. There are numerous software tools that do this, and there's one in particular I like, called Descript. It's not very expensive. You load your videos into Descript, and it uses AI to break each one into five or six shorts, and they're really well made and well subtitled. You can make shorts for each of these, which lets you put them on TikTok, make Instagram reels out of them, and use them anywhere. So you can take this content and repurpose it all over the internet. On top of that, if you do a really nice video, you can transcribe it and use that copy. Say I want to do a page about All-on-X cases. I do a video explaining All-on-X cases, showing lots of before and afters. I run it through Descript and end up with shorts I can put all over my social media, as well as the full video I can put on Facebook and on my YouTube channel. Then I have the transcript, which I can use as the copy for my webpage on All-on-X, coming straight out of my mouth. This is super, super simple. Trust me, I've done it myself. I know I've said "super, super simple" a lot, but it really is.
If you have this playing in your office, as well as all the other tasteful promotion in the office, it plants seeds in patients' minds, especially if they're missing teeth, or they don't like how their teeth look, or they're crooked. Patients will start asking you, "Would I be able to get veneers on these teeth?" or "Would I be able to get this clear aligner thing for these lower teeth?" They'll start asking you these questions. They're already half sold by the time you talk to them, just from sitting in the waiting room or seeing posters on your wall.
If I'm doing this, I would also make sure my staff understand what these procedures are in case patients ask about them. A patient sees a full mouth rehab poster in the reception area, or before and afters of a bunch of cosmetic work, and asks your receptionist, "Would I be a candidate for this?" Your receptionist has to be able to answer that question intelligently. They can't say, "What?" They have to be able to say, "You know what, when you go back with the doctor, I'll mention that to him, and he can sit down and do an exam and explain this." You want to make sure everybody is on the same page.
That gets marketing going inside the practice, to the people who are walking in your four walls. What about your patients of record who aren't walking in? This is where we take it up another notch and start targeting specific patients. You could run a list of people who, for example, are missing teeth and need implants, and target them with a specific campaign: emails, mailers, and so on. I do that here at MGE. When a person fills out a form, they pick the area of their practice that's causing them the most trouble, whether it's new patients, or staff, or case acceptance, or organization. Then I can target specific marketing to that person. Why would I target organizational or management marketing to somebody whose problem is new patients? Or if someone's really interested in profitability, why would I market to them about scheduling? It just doesn't make sense. I target them based on their preferences. Likewise, you can target people based on their problems, and this is not very difficult, because you have treatment plans and you have names. You can pick out who needs these procedures and target specific messages to these people via email, mail, and so on.
If I were doing a series of letters or emails to a patient who needed implants, I would show them lots of before and afters and explain why they need them, or why it's important to get them done, in an easy, accessible way. This is what Google and social media do. I don't know if you've seen this with ad tracking. If you search for a particular item, say a light fixture, the next website you go on, in the banner ad area, there will be something for the light store. How the heck did that get there? They're targeting you based on your prior search. We're not going to go that creepy, but we are taking the information we have about our patients of record, finding out what they need, and marketing what they need to them. This is what new patient funnels do when you have implant funnels. They target specific people who are missing teeth, those people jump through various hoops, and you end up with what you end up with at the end.
You can even do this with Facebook, or used to be able to, and whoever does your Facebook marketing would know this. In theory, you can upload your email list and target those people with particular ads. You're going to have to check the HIPAA aspects of that before you do it, so don't take my advice on that one. I would check that just to be on the safe side. But the idea is that I would at least target with the information I have about the patients and communicate to them about those particular procedures. The funny thing with marketing is that sometimes it takes a repeated message to make the needle move. Maybe they got a letter from you about why implants are important, then another letter about getting their teeth replaced, then another, and they're seeing pictures each time. Finally, that third time, they contact you for a free consultation. And again, make sure you have some type of call to action: "Call me today for a free consultation," or whatever it is. The point is that the more effort and focus you place on this, the better the result is going to be, and it's something you need to monitor regularly.
As you get more and more new patients, obviously we hope our close rate is decent, so we're going to close a lot of them for the treatment they need. But there are going to be ones we don't. This will keep the list from growing too large. If we do this as a regular thing, marketing specific procedures to patients who need them, we'll catch those people in that marketing campaign if they didn't buy the first time they were in the practice. For now, you're probably dealing with a backlog, because most practices have a huge inactive list to begin with.
This is by no means an exhaustive list of anything and everything you can do. There's lots of marketing you could be doing outside the practice, and lots of new patient marketing you should be doing. This is specifically focused on patients of record. If anything, I hope it gets you thinking that you should be placing a huge focus on your current base, along with whatever you're doing for new patient acquisition. The average practice goes new patient crazy and then just loses people. What I would prefer to see is that you get a patient and make every effort you can to get them fully restored: health, function, and aesthetics. Some people are easy and some people are more difficult, and we don't just focus on the easy ones. We focus on everybody. Practices that do this operate at an entirely different, higher level of customer service, patient satisfaction, productivity, and profitability. Ultimately, that's what we want you to have.
Anyway, a lot there. I hope this helps. I kind of just ran on at the end. I was on a roll and just kept talking. If you have questions about any of this, you can always email me at jeffb@mgeonline.com. I have the link on the episode webpage for that reactivation program if you want to check it out. If you have any questions about MGE, you can find us online at mgeonline.com or call us at (800) 640-1140. Folks, have a great week, and we will see you at the next episode.