We all want to improve and do better, so we make changes and implement new ideas…but oftentimes these changes don’t result in actual improvement, or occasionally actually make things worse. So how do you know that you’re solving the right problem? And how do you make sure that you keep the successful things going while making these changes? That’s what Jeff discusses in this week’s episode!
Links:
Download the New Patient Call Log - https://www.mgeonline.com/np-call-log
The MGE New Patient Workshop - https://www.newpatients.net
The MGE Communication & Sales Seminars - https://www.mgeonline.com/abc
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Questions From This Episode
Why does Jeff say tracking where new patients come from is essential before reacting to a drop in new patients?
Without tracking each marketing channel separately, a practice owner might blame the receptionist or cut marketing entirely, when the real cause could be isolated to one specific source. In Jeff's example, referrals and pay-per-click stayed steady while one postcard campaign alone dropped from 25 new patients to just two, immediately pointing to the actual problem.
What real-world example does Jeff give of a well-intentioned change that made results worse?
Years ago, MGE gave its client-outreach team computers and a new sales-tracking program, expecting it to improve performance, but call volume and contacts both dropped because staff spent more time struggling with the new software than actually making calls. Once the stats dropped, Jeff says they simply reversed the change and went back to what had been working.
How does Jeff use the 1985 "New Coke" story to illustrate the risk of poorly examined change?
Coca-Cola changed its formula to compete with Pepsi's sweeter taste, expecting to gain market share, but the backlash was so severe that they had to bring back the original formula as Coca-Cola Classic while New Coke faded away within a few years. Jeff uses it as an example of a change made with good intentions and real investigation that still backfired, underscoring why any change needs to be watched closely and reversed if it isn't working.
What does Jeff recommend a practice owner check before deciding to move locations or add an operatory?
Rather than assuming the practice has physically outgrown its space, he recommends first examining whether the existing schedule is being run efficiently, for example, whether appointments are properly double-booked, or whether dropping PPOs could free up meaningful capacity without any physical expansion at all.
Why does Jeff say buying new equipment, like a scanner or cone beam, isn't always the right move, even when it's a genuinely useful technology?
He points to FOMO, doctors buying equipment because they don't want to be the only one without it, without examining whether their actual case volume justifies the cost, citing years of scanners resold on the secondary market by doctors doing too few crowns a month to make the investment worthwhile. His broader point: a doctor who can't yet sell the treatment they're already diagnosing is unlikely to solve that problem by adding more procedures to offer.
Episode Transcript
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Change is a good thing. We've all heard that before, but is it always true? The simple answer is absolutely not. Change can be beneficial when things are going poorly, but it all depends on what you change. Did you change the correct thing to actually improve the situation? Changing something for the sake of change, or changing the wrong thing, can create issues ranging from mildly annoying to, at worst, company-killing levels of destructive.
Before I get accused of being resistant to change, let me be clear, I'm absolutely not. I make tons of organizational changes over the course of a month, a year, over the years. But when I make one, I tend to thoroughly examine the situation or area first, because I'm trying to end up on the right side of things. What am I going for when I make a change? I'm trying to improve a situation, so I want to make sure the change I'm making is actually going to do that, rather than ending up scrambling to figure out what went wrong afterward.
I've seen this over the years, especially with newer clients or doctors I've talked to throughout my career, where they make some change, a personnel change, a marketing change, an organizational change, and end up in a worse spot, having to dig themselves back out just to get to where they started. So that's what I want to talk about in this week's episode. There are really two things here: how to think logically as a business owner, and how to use that logical thought to make effective changes in your business, changes that actually pay off, as evidenced by your statistics. My name is Jeff Blumberg, and I'm your host.
Let me start with an example, since what I just described can sound a bit abstract. Say you're tracking whether your new patient marketing is working, and all of a sudden your new patients start to tail off. You were getting 50 or 60 a month, and now you're down to the thirties, or even the high twenties. That's a real problem, so you need to do something about it. But what? I've seen people handle this a few different ways: they'll change their marketing entirely or stop marketing altogether, they'll fire their receptionist because "they must be answering the phone badly," or they'll do nothing and just assume the marketing stopped working.
Let's approach this logically instead. Say you were getting 60 new patients a month, and now you're getting 28. Where do you start? You likely have multiple channels bringing in new patients, referrals, pay-per-click, postcards, a newsletter, whatever it might be. Ideally, you should already be tracking what each of these sources is actually bringing into the practice. If you're not doing this, you need to start. You can download our new patient call log for free, where your receptionist is supposed to ask every new patient where they heard about you. This has to become as automatic as answering the phone by the third ring, because without it, you really can't make sound marketing decisions, and marketing is expensive, you don't want to waste the money.
Even if someone calls off a phone number that's specifically tied to, say, your Facebook page, they should still be asked where they actually heard about you, since someone could have seen a postcard, written the number down, and called you off your Facebook page instead. And it's worth digging into specifics: if you're running three different postcard designs, ask which one they saw, what did it look like, was it green with red lettering, so you know exactly which piece is working. Without tracking where new patients come from, it's hard to know what's actually broken.
So say you do track it, and you find your referrals were about the same as the previous two months, no real change there. You check your pay-per-click, Google and Facebook ads, and see you got nine new patients from Google last month versus eight this month, barely a difference, and seven from Facebook last month versus nine this month, actually a bit better. Still not the problem. Then you check your postcard numbers and find you got 25 new patients from your postcard last month, and only two this month. There's your problem.
Without tracking, you might have just said "I'm done with marketing" or "my receptionist is terrible" or shrugged and done nothing. Instead, because you were tracking where new patients came from, you know exactly where the drop happened, your postcard, which was working fine last month and isn't now. As an executive, before making any change, you'd investigate a bit further. Maybe you find out the mailing list got switched to a different zip code, or, and I've genuinely seen this happen, the mail house made an error and sent the postcards to the wrong state entirely, a doctor in Texas once had their postcards mailed to Illinois. Even a great postcard isn't going to generate new patients from a state where nobody's ever heard of your practice.
As an aside, always put your practice address, or even your own home address, on any postcard mailing, so you can personally see when it actually goes out. Once you find out the mailing list changed, the fix is simple: switch it back to the original list. And here's the interesting part, there actually was a change involved, someone changed the mailing list, and that change is what caused the problem. Before making any sweeping changes to the practice, figure out what actually went wrong first, so the change you make is the correct one, in this case, simply reverting to the old list.
You'll find all kinds of things like this: an ad got swapped on Facebook without anyone realizing it, postcards never actually went out, or maybe you put on a new receptionist and nobody's actually listened to how they're handling the phone, maybe they're doing a poor job. But before taking sweeping action in that area, find out what's really wrong so you're solving the actual problem. If I had to summarize where this goes wrong in general, it's that people solve the wrong problem.
Sometimes you make an innocuous change that seems like the obviously right thing to do, and it ends up making things worse. This happened to us years ago in our new client outreach area, the team calling prospective clients. We decided to get everyone computers, since they'd been working off physical lists of prior promotional responses, and set them up with a sales tracking program, kind of like an early version of Salesforce, though nowhere near as advanced. We put them on the new system, and then noticed our stats dropped, fewer calls out, fewer contacts made, the opposite of what you'd hope for after going "high tech." It turned out the team was spending more time fumbling with the new computer software than actually calling people. So once we saw the stats drop, we just pulled the computers and had everyone go back to what had been working before. It was a bad change.
That tells you something important: even when you've thoroughly investigated a change and genuinely believe it'll turn out positively, you should still note exactly what you changed and when, and then watch the results closely. If things start going poorly, and this is something we actually teach in a couple of our courses, you want to change it back rather than leaving it in place just because it's already done. How you reverse it depends on the situation.
Say you had a great receptionist who moved out of state to care for a sick relative, and you hired someone new, and suddenly your new patients drop off. You obviously can't get the old person back. But if the new hire is genuinely a good hire, there's likely something the old receptionist did that the new one isn't doing, or something the new one is doing that the old one didn't. You'd want to train them to replicate what worked before as closely as possible, you could even pay your old receptionist for a bit of phone-based training with the new hire to get them up to speed. It's not always a case of "you can't fix this," sometimes you can, sometimes you genuinely can't. Or say your receptionist wanted to move to the back and train as a dental assistant, so you trained a replacement up front, and new patients start dropping. Now that former receptionist might need to step away from their new assistant role temporarily to retrain the new hire, or the new hire just isn't cut out for the position, something ideally you'd catch before moving anyone around, but if you didn't, you either retrain or replace. That's why change, on its own, can be either genuinely constructive or horribly destructive.
If you've been around a while, you might remember Coca-Cola's formula change back in 1985. For anyone younger, here's the story: Coke was losing market share to Pepsi, since Pepsi was sweeter, so they launched an entirely new formula called New Coke. I was a teenager at the time and a loyal Coke drinker, this was before bottled water was really a thing, you drank Coke or you drank from the hose. New Coke was a disaster. People were furious, my friend's dad had a section of his garage filled with cases of old-formula Coke cans he'd stockpiled because New Coke was so bad. I switched to RC Cola for a while because I couldn't stand Pepsi either. Eventually, and to their credit, Coke reverted, bringing back the original formula under the name Coca-Cola Classic, while New Coke quietly disappeared within a few years since nobody wanted it. If you wanted new-formula soda, you'd just buy Pepsi at that point. There's a book on this by Sergio Zyman, who was the chief marketing officer at Coke during that period, called The End of Marketing as We Know It, if you want the full story. The point is, that was a genuinely destructive change made with good intentions, an attempt to grow market share against Pepsi, that actually cost them market share instead.
You have to be careful making changes like this. Say you feel maxed out, the practice is genuinely busy, you've run out of physical space, maybe you're only configured for three operatories and there's no adjacent suite to expand into. So you decide you need to move, or add a room if that's even possible. A new office isn't cheap, and neither is an expansion, so before making an expensive decision like that, you want to thoroughly examine whether it's actually the right one. This doesn't have to take years, it can be done quickly. If a client tells me they want to move or think they've maxed out their space, the first thing I look at is their schedule. Maybe it's being run inefficiently, one doctor scheduling linearly, one patient after the next, without properly double-booking. Or maybe they've been talking about dropping PPOs, in which case I might suggest starting there instead, since you could lose up to 30 percent of patients on a given plan without losing revenue, but as new full-fee patients fill in behind them, your existing schedule might actually absorb more production without any physical expansion at all. You want to examine this thoroughly before jumping straight to an expensive decision.
This is where FOMO comes in, fear of missing out, a term you hear a lot in investing or crypto circles, but it shows up here too. I need this new scanner, I need that cone beam, I can't be the only doctor in town without same-day crowns. People buy equipment like this without actually examining whether they'll use it enough to justify it. For years, one of the biggest problems for a certain milling system brand was the flood of used units on the secondary market from doctors who'd bought one out of FOMO, only to realize they were doing four or five crowns a month, and it would have been cheaper to just keep using a lab. Same story with cone beams for doctors doing only one or two implants a month. I'm not against offering patients what's genuinely best for them, but you have to look at these purchases logically, or you end up in a mess.
I was talking to Jeff Santone, who you've heard on prior episodes, he handles our new client acquisition, about a potential client he'd spoken with. She'd just opened a new practice, hardly any patients yet, and wasn't getting many new patients either. She couldn't decide whether to invest in getting more new patients or buy a scanner. Now, I'm generally a fan of scanners, I think it's smart, and it's clearly where the industry is heading if you're not already using one. But if you have almost no patients, why would getting a scanner be the priority right now? Get some patients first, logically speaking, so you can actually afford the scanner payment once you have one. That's the logical thinking that FOMO tends to short-circuit.
I see the same pattern with adding services generally. I like being able to offer patients more, there's nothing wrong with being a one-stop shop, or offering things not every practice does, sleep apnea treatment, implant-supported dentures, All-on-4s, whatever it might be. We have clients who do a ton of this, and we're even partnered with a company delivering courses on things like All-on-4. These are great services. But if I'm talking to a doctor who can't sell the treatment they're already diagnosing, say a patient needs three crowns and only wants to do what insurance covers, and the doctor doesn't know how to handle that conversation, or a patient won't accept a treatment plan and the doctor can't get them there, then "I just need to learn more procedures" doesn't really solve anything. It's great to learn how to place implants, sure, but if you can't sell the dentistry you're already diagnosing, why would implants be any different?
This is where you have to step back and think logically. We advertise heavily for the MGE New Patient Workshop, I'll put a link on the episode webpage if you want to learn more, that's my one shameless plug for this episode. But say a doctor's getting 20 or 30 new patients a month, and half of those patients only want what insurance covers, and revenue isn't where the doctor wants it to be. The instinct is almost always, "I need more new patients." You should absolutely still work on getting more new patients, but the idea that you also need to learn how to get existing patients to actually accept their treatment plans, how to communicate in a way that makes them understand and want the treatment, often doesn't even cross the doctor's mind.
Why not? Think about it: say you're producing $75,000 a month, getting 25 to 30 new patients monthly, and you want to hit $100,000. You've got open time on the schedule, so the obvious conclusion is you need more new patients. Let's say you've got three to four thousand charts and one full-time hygienist. If that's the case, you're likely not seeing enough hygiene patients relative to your chart count, meaning you're wasting and not retaining the patients you already have. And if you look at how much diagnosed treatment isn't being accepted, you'll probably find a substantial amount, just pull up your own incomplete treatment list, there's likely millions of dollars sitting on it.
The idea that someone could actually teach you, or your team, how to communicate with those patients in a way that gets them to say yes might feel completely foreign, because you're not a bad communicator, you're a smart doctor, so surely patients just don't care, or only want what insurance covers, right? That's not actually the case. There are real, learnable ways to help patients genuinely want the treatment they need, but that solution doesn't occur to a lot of doctors because it seems impossible or beside the point. So the only lever that gets pulled is new patients. You should get more new patients, but you need both: learning to sell what you're already diagnosing gets patients healthier, increases your collections, improves overall practice productivity, and fills those open slots on your schedule.
So look at things logically: what's the actual objective? Say it's producing $100,000 a month. Why aren't you there yet? You've got open time, why isn't it filled? Maybe you diagnosed $50,000 worth of treatment this week and patients only accepted $5,000 of it. What happened to the other $45,000? If even half of that had been accepted, you likely wouldn't have any open time left.
This was a bit of an abstract topic for an episode, but I wanted to bring it up because I see too many people get themselves into expensive mistakes, or head down paths that don't actually lead toward the objective they're trying to hit, and end up in real trouble. It's not a fun place to be. I've operated on a kind of personal policy over the years: I'd rather do three things really well than ten things kind of okay. I don't want to spread myself so thin chasing every idea that nothing actually gets done well. I'd rather focus on what I can genuinely execute and build from there as a solid foundation.
So if you feel like you've got good control over your office, solid new patient flow, a strong team, and good case acceptance, patients listen to you, want the treatment you present, and accept it, then you're in a good position to build on that, add procedures, add services, whatever direction you want to grow in. But if you're still struggling with those basics, jumping straight to a move, a new operatory, or a big equipment purchase is just going to be your next expensive mistake and a lot of added stress. It's the wrong change.
So keep that in mind. When you do make changes, know exactly what you changed and keep a close eye on it, and if it doesn't turn out the way you wanted, do something about it, reverse it if needed. And before jumping into twenty different initiatives at once, get what you're already doing done well first, and build on top of that.
This was a fairly simple episode, but I hope it helps. I'll put the links I mentioned, the call log, the New Patient Workshop, and so on, on the episode webpage. If you have any questions about any of this, or about MGE generally, you can call us at (800) 640-1140 or find us online at mgeonline.com. I hope this gives you something to think about with relation to your own office. Have a great week, and I'll see you at the next episode.