S1 00:02.189 [music] Welcome to the Double Your Production podcast with The Team Training Institute. The one place designed for dentists and their staff who want to grow their practices by following in the footsteps of those that have done it, who are in the trenches, who know exactly what you’re going through. And now your leaders, the stars of the podcast, Dr. John Meis and Wendy Briggs.
S2 00:24.534 Hello, everyone, and welcome to the Double Your Production podcast. My name is Katie Smith, and I will be your host for today. I’m lucky enough to be here with Wendy Briggs and John Meis. They’re going to continue expounding on concepts that will help us double our production tomorrow. To just summarize our first episode, we talked a little bit about our office roadmap, figuring out where you’d like to go, creating goals to get there. We talked about practice growth with ideas to help us solve our new patient problem by more effectively treating those patients currently in our office or in our chairs. Wendy brought up the three roles of a hygienist and how the Hygiene Explosion program that we teach here at Team Training Institute can really help you to do just that, explode your hygiene department or your hygiene production. So now, for today, we’re first going to address what we call the hygiene roller coaster that really does apply to the entire schedule. Our hygiene roller coaster is when you have patients that seem to continually drop the same day creating holes in the schedule that keep you waiting around and then later in the afternoon you could be slammed and running around. Can’t quite seem to catch up from that schedule. Another problem that we have is those emergency patients.
They come in and then you never see them again. You could be spending money on marketing that only brings in those one-time emergency patients or no patients at all. So Dr. John, I’m going to turn the time over to you. Talk about our step three, which is retention.
S3 01:46.985 Absolutely. Thanks, Katie. Hello, everybody. And this is a really important thing that has been so undervalued in practices. We have done a long-term study in 120 dental practices looking at the things that affect profitability. And it’s quite amazing that when we look at marketing dollars spent, marketing dollars spent has no correlation with profitability in an office. But guess what does? The retention of the current patients you already have. So we want to talk about how we bring this to the next level, because it’s so often undervalued, underperformed, and is a huge lever for improving the productivity of your office. So Wendy, why don’t we start walking through some of the things that we’ve learned and experienced when it comes to retention?
S4 02:43.657 Absolutely. On our last episode we talked a lot about how every single dentist we talk to seems to think that they need more new patients to achieve their goals and to grow their practices. And what we found is some may need those new patients, but more often than not they need to do more with the patients they have, and that includes better systems for retention. We talk a lot about retention. In fact, we teach Seven R’s, and retention is one of those Seven R’s. We’ll dive into three of those R’s today pretty heavily, because retention is so important. And recall and recovery feed retention. They are directly related to that. So, when we look at the process that practices have, practices that continue to grow and add hygiene providers more often than the average have really great systems in place for retention. And they’re tracking retention. They’re looking at these numbers. They have a statistic or a dashboard and they can easily look and see, how many of our patients that we saw today pre-scheduled for their next visit? This is really, really critically important to measure and to track and keep your finger on the pulse of all the time. You know, when we start working with practices it’s not uncommon to find out that they’re not measuring this at all. They don’t even look at it on a monthly basis. Ideally, it’s a daily basis that we’re looking to see how well we’re retaining patients, because it can be such a tremendous driver for practice growth.
S3 04:07.310 So, when we talk about looking daily at patient retention, what exactly are people looking for? At the office level, what are we doing to identify how we’re doing on retention?
S4 04:20.953 The easiest way is to have a dashboard that can find that data for you. You know, many of our practices are using an outside service, like Dental Intel or Dental Practice Pro that can actually see those numbers at a glance. If you don’t have one of those– what they’re looking for on those dashboards, by the way, is how many of the patients they saw in hygiene have already scheduled their next visit. So say we saw 37 patients today in hygiene with multiple hygiene providers. And that report can show us at the end of the day that only 32 of those patients pre-scheduled for their next visit. So the practices that really hitting a home run on this have a plan in place and systems in place for what they do immediately to address those five that did not pre-schedule. So there are practices that are really working hard at this that have those systems in place. And then, there’s the other side of the spectrum, which is people who really don’t even know what’s happening here.
S3 05:12.730 That’s for sure. Though, where they identify those five patients, then there’s a plan, right? So the plan is we’re going to try to get those five to schedule. If they refuse to schedule, we’re going to make sure that it’s documented in the patient’s chart for medical legal reasons.
S4 05:27.496 Exactly. So if we call them today and say, “Hey, I just noticed that while you were here today we neglected to schedule your next visit. Let’s get that taken care of so that when that time rolls around you have your first priority appointment time.” It’s a lot easier to recover that than to wait and try and contact that patient six, seven, eight, nine, a year later. So that’s the whole idea is to solidify that. Tighten that up so that we have a well-oiled machine. And we’re not losing that opportunity to retain those patients and keep them in the schedule, keep them enrolled in the schedule.
S3 06:02.125 So this is really kind of the first step that sets up the recall system, is to make sure everybody’s got a next appointment, right?
S4 06:09.251 Absolutely.
S3 06:10.541 And so then the next part of the recall system is making sure that we have a system to remind patients of their upcoming visit as we get closer to it. So we’ve seen a lot of different things that have worked with this. We’ve seen some things that haven’t worked so well. So one of the things that we know now is there’s a lot of technology that helps make this more efficient. And the challenge is, how do you make it more efficient while still keeping it personal? So what are some of the things that you’ve seen people do, Wendy, that really improve this?
S4 06:42.752 Well, I think that the key really is that it’s got to be a combination of technology and personal touches. So email and text reminders, for example, are fantastic, but we have to have a very clearly defined system. A systematic way of knowing if they don’t respond to the week-before email, if they don’t respond to the text message, what then happens? So we are seeing email and text being a great adjunctive option for practices to utilize, but we see danger if we become too heavily dependent and think that the technology will do it all. So the best process for this is a combination of the two. You know, if we can go ahead and send that email reminder out, and if they respond via email at the one week in advance notice, by example, then they may not need a reminder call. But if they don’t reply to email or text then we follow it up with a phone call. So we’re seeing a systematic process for utilizing personal and technology resources being the best most effective strategy.
S3 07:41.755 So one of the keys to recall is that we’re building a relationship with the patient. A relationship isn’t computer to cell phone. A relationship is person-to-person. And one of the things that is so important is that many people prefer a technological aspect. Many people prefer a personal touch. So you really have to identify which is which or to make sure that you’re covering both in one way or another. What you describe is really fantastic. And the recall calls can be done by anybody in the office, but may be best done by the person that has the best relationship with them.
S4 08:22.744 Absolutely. And that’s the thing too is I think probably the most common mistake that we see with this is not enough contact. Some practices think they have too much already, but these appointments that were pre-scheduled three, four, six months previously, we love to see on the hygiene side a one week in advance reminder. That can be an email followed up with a phone call if they don’t reply. Like we said, it just depends on what that particular patient prefers, but we’ve got to do a one week in advance reminder. And then we see that the next step being the day-before confirmation call or the last-minute reminder, last-minute courtesy reminder as many calls that. We don’t do the one week in advance reminder plus the day-before confirmation. That’s when we tend to see a lot of problems with open time, no-shows, last-minute cancellations. Because the practices are having to rebuild their schedules the day before when patients are being given that confirmation call and they’re realizing that that appointment time does not work for them. So you’re exactly right, Dr. John. Building the relationship is what it’s all about when it comes to patient retention. But we also have to recognize that our society has changed and people are very, very busy. And it takes a systematic process and people who are dedicated to following through on that process to really get this job done and solidify our schedule.
S3 09:38.263 And many offices who don’t do this well, the reason they don’t do it well is they think of it as one of those duties they will get to when they have time. This is not one of those duties. This is prime time. Time set aside. Has to be done. Has to be done 100%. Has to be done, every patient, every day. This is a key factor in the growth of the practice.
S4 10:00.083 I could not agree more.
S3 10:00.899 Yeah. So despite having all of these systems in place, we know that they’re not going to be 100%. We know that people are going to call and cancel or they’re just not going to show up or they refuse to make an appointment at their last visit, and so now we have this, hopefully a small group of people–
S4 10:19.751 And with those people, despite all of pre-scheduling and all that, sometimes they’re going to fall out. And when they do fall out, then we need to go ahead and get on the phones, contact them and apply our recall effort. With those patients, the most significant thing is the message that we’re leaving. What message are we leaving to get these patients into the schedule? And those who have had coaching with us and who have done our online course, we get into a lot of detail about scripts and things that we can say. The most powerful phrase that we have found on that phone call is, it’s important that you call me as soon as possible regarding your appointment. That phrase prompts a return phone call and when they call and say, “What appointment? I don’t have an appointment.” We usually teach team members to smile and say, ”We know. That’s why we called. We called to help you schedule your appointment.” So making the effort, just like you said before Dr. John, this is something that has to be scheduled. There has to be time. We can’t get to these recall phone calls when we have time otherwise they will never get done. That’s so true. When we have last-minute changes to the schedule, when patients fall out of the schedule for today or tomorrow. Then we have to go into recovery mode and we often see practices go to their unscheduled appointment list or broken appointment list for those open times. And I can’t say this strongly enough, that is the last place you want to go because you really don’t have a very high likelihood of success in that mode for recovery. So if we have last-minute changes to the schedule for today or tomorrow that’s when we go into recovery mode and we are utilizing to practice’s software. Almost every software has built in ASAP lists, quick filler lists, sooner-if-possible buttons to click and so there’s a big difference in our mind between recall mode and recovery mode. Both of them though are really critical for retentions. Obviously, we don’t have time to cover everything that we teach with these systems on this podcast. In fact, if we teach the seven Rs, that’s a full day course. So there’s a lot, a lot of information about systems that are required to keep the hygiene schedule full– the practice schedule full, and how critically important that is in all of those. All of those systems help us retain patients at a much higher level, which helps our practice grow.
S3 12:24.125 When I talk to older practitioners, they talk about that patients kind of held the appointments that they made sacred and they really showed up really well. Over time, I think that that’s changed. I think just the way people think in society about appointments has changed. And so now we have to be much more flexible in how we appoint people, how we keep people scheduled, and it takes a lot more effort now than it used to, doesn’t it?
S4 12:54.208 It absolutely does. And there’s adaptive strategies that we teach that can help practices thrive in spite of those changes to society.
S2 13:02.211 Going back to the basics of creating that relationship with the patients, we’re going to move forward to our step four which is actually building a connection and it leads right into that. Dr. John, tell me about how we can best have our team start building that connection and that personal touch with their patients.
S3 13:17.864 There are so many little things on this, Katie, that makes such a big difference. They don’t seem like they’re big, but they really are. For instance, calling someone by name when they walk in the door, standing up, looking at them eye-to-eye, smiling, paying attention to people. One of my favorite videos from our secret shopper video process is a absolutely completely disconnected front desk person, who is not only disconnected, she’s rude. And so I’ll just walk through some of the things that I know that make a huge difference on connection. So one of them is using the patient’s name over and over and over again. Another one is wearing a name tag so they know your name and they can use your name all the time. Those two things seem so small, but they’re really huge. Wendy?
S4 14:13.795 Yeah. They are. And this is so important too because when we look back at the previous episode and we were talking about creating a foundation and a roadmap and knowing why you practice. This is so important because for many of us building the connections with our patients and being able to serve them at a higher level and really have an impact on our community, it’s a big part of our, why. It’s a big part of why we practice. And what I often see with team members that are disconnected, is that they have lost sight of the, why. Right? They don’t have clarity, they’re not 100% focused on where we’re going, what our vision is, why we’re really here. And I understand. I mean, I get it. It can be overwhelming up front. It can be overwhelming in any position in the dental practice. With especially many of our practices that we serve, they’re very fast paced, they’re busy, and we have a lot of tasks that we need to accomplish every single day. So we could sometimes have, phones are ringing, we’ve got a new patient waiting to schedule. We’ve got two or three people right in front of us that we’re trying to serve, and it can be really overwhelming. And I think part of the realities that we face, often we see this time and time again, is that we run too lean on our team members. We may not have enough team members to really serve the volume of patients that we’re seeing. We see this happen time and time again. That could be a part of the issue, but more often than not they’re just, as you mentioned, disconnected because they’ve lost sight of the, why. Why are we really here? Why are we taking care of the patients that we serve? And if we don’t have that, if we don’t have clarity on the vision, nothing that we say to our team will matter. Unengaged employees cannot create engaged patients; it’s just not possible.
S3 15:49.762 And one of the things that we teach in our higher-level course is how to make that emotional connection. How to identify the emotional state of the patient? How do you show empathy and respect to wherever they are? And really being able to listen, and empathize, and build rapport with patients is something that is really very mechanical set of steps that you can take to get there. So, it’s not– I think a lot of people think that it’s a talent. Oh, she’s a people person, or he’s a people person. No there is a certain set of tactical steps that you take, and when you take those steps you build a connection. Some people do it naturally. Some people need to understand the steps and walk through them, but without doing that, without carefully listening to the patient and understanding where they’re coming from, you’re never going to build a connection. And we see in so many practices what we call the one-and-done. Where the patient comes in one time and they never come back. That can be in most practices, in the average practice, that’s about 35% of the new patients that they see. And my belief is that the main reason that we have one-and-dones is that we fail to make emotional connection and we fail to solve the problem that the patient had when they came in.
S4 17:01.545 As they define them too. Sometimes we can listen to their problem, but we’re listening with the intent to respond. We are not really listening and asking great questions and trying to determine what they want to do about the problem that they’re having. A lot of times we’re providing the solution that we feel is best rather than listening to what they’re interested in doing. And this is so critical and we get into a lot of amazing details. I love listening to your teach your Clinical Explosion program because it’s just so brilliantly presented. How we can utilize specific questions and language to communicate at a higher level. We teach the principle of tribal language and having the team speak languages that the patients can understand and part of building that emotional connection. So what we say and how we say it does matter. It has a huge impact on whether patients are going to accept the care that we’re presenting, whether or not we are listening well enough to present the care that the patient is interested in. There’s another big part of it.
S3 17:58.967 Exactly [crosstalk].
S4 17:59.706 And this is why we talk about– in the first episode we mentioned the hygienists’ three roles of hygiene and this is why we spend so much time on this role as the hygienist, as the patient treatment advocate, because there’s so much we can do better in that role. Even if it’s just utilizing technology at a higher level. Utilizing the cavity detecting lasers and the intro cameras to build that connection, and to present the care that the patient needs in a way that they can become emotionally connected to that. It’s such an important critical part of what we do every day, and that step forward building a connection is often a game changer for many of the dentists that we work with.
S3 18:34.773 Oh, for sure it is. This building a connection is a team sport. It starts from the very minute the patient calls, to the minute that they walk into the door, to the minute there’s a transfer to the clinical team, to the minute there’s a transfer from the clinical team to the doctor part of the clinical team, and then a transfer back to business office team. It is a team sport and the communication between all those steps if it’s not done well the patient loses trust at every step of the way. And patient trust, patient relationship, is why we have one-and-dones and why retention suffers from that because they really never made a connection with us. We never built a relationship with them, and they’re gone. And usually, once they’re gone, they’re gone for good.
S4 19:20.567 Yeah. I can’t agree more. And patient experience is such a critical element. I mean, when we talk about building a connection we’ve also taken it a few steps deeper than that into the 65 points of contact in every new patient experience. There are so many opportunities in those 65 touch-points to build that connection. And that’s why we talk about world-class patient experiences. That’s why we talk about how important it is that we are focused and connected and paying attention to what our patients are saying. And using all of the technology that we have. All of those little elements. Each step by itself isn’t going to make a huge impact, but we need to take all of those little steps combined and add that up. It can create a world-class patient experience. And if we’re doing it well, we’re building connections all the way through that. So in the show notes for this episode, we’ll include some of these resources. We’ll be able to provide that 65 Points of Contact reference sheet. We’ll give that to you as a gift for listening to this episode today. And we’ll have some other great resources for you in the show notes.
S3 20:21.090 Terrific.
S2 20:22.693 All right. So as you can image, Dr. John and Wendy really have been there themselves. In their own practices as well as the practices all over the country that they’re currently working with. They are experts in creating that connection that they’ve talked about with the current patients in your chair, as well as the new patients that come to see you. And these patients create almost an in-house marketing, if you will. They refer their friends and family and let them know where they’re getting good care. So if you’ve liked what you’ve heard today, go ahead and jump on and download episode three of this three-part series. Or if you haven’t listened to episode one you can also find that at www.theteamtraininginstitute.com/podcast. There, you can find the show notes and any other references we’ve talked about in this episode. So thanks much for tuning in. We look forward to continuing bettering our practices and serving our patients at a higher level. [music]
