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We started by asking consultants from around the country three simple questions. What we got back from them was very interesting and informative.
As a follow-up to the article showing Sikka Software data on the rate of six-month checkups being reappointed (see link below), we threw out these three questions to the consulting world.
What’s the biggest reason you believe patients don’t come back into the practice for their six-month appointments?
What’s the biggest tip you could give practices to avoid that from happening?
What have you seen personally work in your practice or practices you have consulted with?
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See related article: See you in six months: The hygienist’s role in getting the patient back
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Sounds simple, right? Well, just like every person is different, every consultant has a different way of looking at things.
Here is what Jamie says she has learned through working more than 30 years “in the trenches” as a hygienist and five years as an assistant.
What’s the biggest reason you believe patients don’t come back into the practice for their six-month appointments?
People do not comply to any of our recommendations (and it doesn’t matter if it is 2-, 3- or 6-month intervals, restorative needs, homecare protocol, or even showing up for their appointment on time) unless we speak to the patient’s why. “Why should I spend more of my precious time and money doing what you are recommending?” When we are wanting change that is understood and that lasts, we have to address their emotional why first, the rational why secondly.
For instance, here is the rational why: “Mrs. Jones, you haven’t been in for a while, and it is important that you come in and see me every six months. This is important so if you get a cavity or an infection in your gums we can diagnose it sooner.”[Native Advertisement]
Here is the emotional why: “Mrs. Jones, I am concerned that it has been a while since we last saw you. Since your last visit, you indicated that you are now diabetic (or whatever medical changes have occurred), and we now know that what goes on in your mouth and gums can have a direct effect on your A1c levels. What are your thoughts and feelings?”
Mrs. Jones probably lives and dies (so to speak) by her diet, insulin dosing, and checking her glucose levels. You have touched on her why, which is also the truth about our rational why. The patient’s emotional why can be anything. You just have to listen to what he or she is sharing with you either through the answers to your questions, or items that he or she freely shares with you.
What’s the biggest tip you could give practices to avoid that from happening?
Building value as mentioned in the first question helps solve the second question. Building value for all requests and recommendations by attaching the emotional why to the solution (suggested protocol and treatment).
What have you seen personally work in your practice or practices you have consulted with?
If the patient has missed or cancelled an appointment for whatever reason, patient communication systems, personal touch with phone call, etc., all work. The number one thing I put into action with past due patients and my teams is simple. The list has to be worked (reaching out by phone call first, 30-60-90 days past due) routinely and one person on the team has to be responsible for it.
So I ask the admin team member (patient care coordinator, for example) what day of week and time of day is the least stressful (So they can pick no excuses, right?). They say something like Friday at 9 a.m. Okay, we now create a task priority block every Friday at 9-10:30, where you go to a private phone area (no greeting patients, answering incoming calls, or checking out patients) and work that list. Keep everything in your office software (date called, message left, patient request for call back, etc.) with your initials and date called.
If Jamie the RDH now looks a week ahead at her schedule and sees holes, when she gets an open hour, she gets on the phone, and calls her personal patients who have already been notified by the patient care coordinator a few weeks or months earlier.
Practice management consultant Jan Keller said this:
What is biggest reason you believe patients don’t come back in to practice for their 6 month appointments?
Typically, it is for one of the following reasons:
The patients do not perceive the value and therefore no need to either pre-schedule or no consequences/follow through when they cancel and don’t immediately reschedule.
The patient perceived that it is not important to the practice—if when they call, they hear from the administrative team that is “it is okay” to cancel. Feeble attempts are made to reschedule or promote keeping the appointment by the team.
No clear system in place to contact people who did not reschedule at their last hygiene visit. The system in place has been our schedule is empty so “let’s make calls” rather than having a specific protocol in place to follow.
The patient does not feel the “wow” anymore. The honeymoon is over. We become lax in our customer service once the patient is a patient of record. The practice falls short of continuing their excellent customer service skills, and patients walk quietly out the back door, feeling they are not going to be missed and most likely aren’t until the hygiene schedule starts to fall apart.
What is biggest tip you could give practices to avoid that from happening?
At a team meeting, the practice should develop a clear understanding of the vision and philosophy of the hygiene department. What are the expectations of each member’s role in the success of the hygiene department? Develop specific protocols for the various critical elements of the recare department and follow through with their effectiveness.
What have you seen personally work in your practice or practices you have consulted with?
When offices discuss this area of the practice, set their vision and philosophy for this very critical department. Develop the roles of each individual on the team and how they impact this area of the growth of the practice. Also, it is important to note how they are given education and work on verbiage, develop the protocols of the elements of the recare depart, set the expectations, and then monitor them monthly. When this happens, an improvement is always realized in the hygiene department.
Without monitoring or having consequences for not following protocol, then the recare department will continue to spin their wheels to improve.
It is not enough to be excited about how many new patients have come into the practice each month if you don’t monitor how many patients have gone out the back door quietly. It is important to know why patients are leaving and have a system in place to follow through with patients and find out the patient’s reason for leaving and how the practice can make changes to improve. You need to ask and be prepared to take action when you find out the reasons why.
I have found that it is important for the practice to have confidence, consistency, courage, great communication, and a plan to co-diagnose (hand off the patient to the doctor during the exam and handoff again from hygiene visit to the administrative team). The five Cs mentioned above are critical in this process.
Practices that have developed “want-based” questions that the hygienist asks during the hygiene appointment, is helpful in help direct the patient to receiving the type of dental care they not only want but they need.
Andre Shirdan had this to say:
What’s the biggest reason you believe patients don’t come back into the practice for their six-month appointments?
There is a considerable change in the last two decades in dentistry. Patient focus has shifted from health to cost. The return on investment shifted from pain-to-income ratio to pain-to-time ratio. There is no time and the fear of “pain” has been replaced with “urgent” emergency visits to the dentist and lower recurrence of decay.
What’s the biggest tip you could give practices to avoid that from happening?
Stop looking at “recall” like a vacation (something that happens bi-annually) and start thinking about recall like trips to the spa, trips to get your hair done, or trips to a nice restaurant. These are things that you want to do to “pamper” yourself. There is no reason that patient can “only come twice a year.” Heck, they can come anytime they want. Their insurance carrier may only contribute to the visit twice but not “having a coupon” doesn’t stop people for going to the Cheesecake Factory more than twice a year.
What have you seen personally work in your practice or practices you have consulted with?
Creating continued care programs that allow patients to set visit cycles that meet “their” needs. “Joan, we’ve gotten your smile bright and your gums healthy. How often do you think we should see you?”
Note: Want to learn more about what Sikka Software can do for your practice? Practice Mobilizer is the free app that lets you send HIPAA-compliant video messages, track patient arrival times, provides zip code specific fee data and more. Click here. Link to www.practicemobilizer.com.
An advocate of today’s dental assistant, Kevin Henry speaks to dental audiences across the nation on topics that empower dental assistants, helping them recognize the leadership role they hold in the dental practice. He is the cofounder of IgniteDA.net, a community designed to enlighten, empower, and educate dental assistants.
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