Home Issues2023 Digital Dentistry Why Can’t I Get More New Patients? Part 2 of 2

Why Can’t I Get More New Patients? Part 2 of 2

A Guide to Understanding the Real Challenges Suffocating Your New Patient & Practice Growth Part 2: Lost Opportunity

by Chris Phelps

The Dental Marketing Cycle

In Part 1 of our story, I talked about the 7 Pillars of Marketing that are critical for your lead generation efforts to maximize the quantity and quality of new patients that your marketing will Attract.  But is this all we need to be concerned about?  Are there other factors we must consider that negatively implant the new patient numbers we need to grow our practices successfully? 

There was a time several years ago where I found myself spending $36,000 a month in dental marketing to cover two of my offices.  The fruit of those efforts?  A grand total of 60 new patients.  Half going to one of my offices and half going to the other.  When I narrowed my focus to the 5 most important areas that I addressed in Part 1 that you need to track in dental marketing, I discovered that my teams didn’t answer 254 marketing-based phone calls a month.  If we did answer, we only made an appointment 24% of the time.  Capping it all off by matching the national average with a 17% no show rate. 

While generating new patient opportunities are great, if our team is unable to make that person an appointment, if patients scheduled don’t show up for their appointment, refuse to accept and return for the treatment presented to them or future hygiene visits then it will cost us more in marketing dollars to make up for the errors made here.  Let’s now turn our attention to the other half of the Dental Marketing Cycle and how the Lost Opportunity that occurs here could be slowly killing your marketing’s success along with your practice’s growth. 


The Attendance phase of the dental marketing cycle is defined by your ability to answer new patient phone calls, schedule new patient calls and influence those patients to show up in your practice. 

  1. New Patient Calls: Studies show that the average general dental office in the US, spending less than $2,000 per month in marketing, is unable to answer about one third of their new patient phone calls.  For offices spending over $2,000/month in marketing, the missed call rate increases to almost 50%.  Reasons for this range from having a lack of team members dedicated to answering new patient calls, too many existing patients calling and recalling to make their appointments and no real system of tracking to find out if and when this is occurring. 
  2. Scheduling Appointments: For a fee for service office, out of network with dental insurance, the average office here only makes an appointment around 34% of the time.  For PPO offices, in network with that dental insurance plan, the appointment rates range from 47-49%.  Still missing out on half of the opportunity.  Of the appointments not scheduled, these fall into two categories.  Things within our team’s control and those outside of that control.  Things out of the team members control are items such as a patient calling for an office who is open on Saturdays, the only day of the week they can come in and be seen but unfortunately, your office is closed on Saturdays.  With this patient mindset entrenched, it makes it next to impossible to change.  Ending with an appointment not being made.  Items within their control would be things such as a person asking “How much is your cleaning?  How much is your crown?”.  Here, we find a mindset that be modified in the moment.  Leading to an appointment scheduled if the right strategies and language is utilized. 
  3. No Show Rate: As mentioned earlier, the nationwide average here fluctuates between 17-24%.  With online advertising mediums producing the highest percentage of no shows across any other marketing medium.  The Top 10% of offices have a no show rate between 8-10%.  The fundamental reason the ball gets dropped here is a failure to get a real commitment out of the patient on the telephone.  From an influence standpoint, you can leverage the Principle of Consistency to get better commitments out of the patient on the telephone that will persuade them to show.  In my own office, utilizing this Principle helped me reduce my no-show rate from 17% to less than 3%. 


The Acceptance phase of the dental marketing cycle can be defined as follows.  If you presented treatment to patients, was that treatment accepted and did they return to begin that treatment?  If surveyed, most Dentists who are about to go through my Influence and Persuasion workshops report that they feel like people say No to their treatment recommendations because they simply can’t afford it.  If influenced properly, the reality is that the cost of the treatment has very little to do with what people are using to make the decision.  Let’s look at what behavioral science studies show us are the top 4 reasons why patients say No to your treatment recommendations. 

  1. Mindset: Whether you realize it or not, when a patient walks through the door of your practice, they are coming in with a mindset already established.  If you do nothing to influence a different mindset, then most likely whatever they are focused on will distract them from what you are discussing or is in direct competition with what you are presenting.    This treatment or my upcoming family vacation. 
  2. Lack of Relationship: People love to say Yes to those they know and like and No to those they don’t.  How often have you failed to connect with your patient on some level because you were too busy, in a rush, or distracted by a different patient or treatment going on in a different room?  Without establishing a strong relationship with our patients, they don’t tend to move forward with or trust the treatment you recommend.
  3. Uncertainty: If there is any kind of questions, doubt or uncertainty present in the patient’s mindset, then they don’t say Yes.  Sometimes the uncertainty comes from you or one of your team members who may personally feel that the treatment is too expensive.  Passing on that impression to the patient, whether you realize it or not.  Oftentimes the uncertainty is created by giving the patient too many treatment options and then leaving it up to the financial team to help the patient navigate the path to the answer.  Imagine it if you give the patient 3 treatment options and then the financial team comes in and presents 3 financial options to each of your 3 treatment options.  Now the patient has 9 things to choose from, barely understanding the differences between any of them.  No wonder it makes more sense, seems safer if you will for them to choose to do nothing.
  4. Lack of Urgency: I call this one the “I got time” mindset.  If we fail to motivate the patient to want the treatment, to create some urgency and that it would be better if they did not wait to start, then the patient will take all the time in the world to move forward.  Typically happening when the situation has worsened to the point where pain is now present.  


Our last area of Lost Opportunity is the Attrition phase.  When all is said and done, are these patients that you’ve invested so much with to this point, returning for future treatment?  If you don’t know the answer, you need to because numerous studies tell us that it costs you 4 times the amount in marketing dollars spent to replace a lost patient versus just retaining them. 

There are lots of ways that you can calculate your patient attrition rate.  For simplicities sake, I prefer to focus just on those patients not returning in hygiene.  Flashing back in time twelve months, I identify the names of all of the patients who came into hygiene that month. 

That includes new and existing patients.  From there, I take that list of names and compare that to the current month’s schedule.  In theory, had they been coming every 6 months, then you should find them on your schedule.  If you see them, then there still an active patient.  If you don’t see them on the schedule this month or in the coming months, then I consider them lost. 

At a minimum, your new patient count must equal your monthly attrition rate, just to break even.  Hopefully replacing the production lost with new production gained.  For your practice to grow, your marketing efforts need to drive in a new patient count that exceeds your monthly attrition rate. 

So why do patients leave your practice?  While money and a bad experience are both acceptable answers, there are a couple others that could be significantly impacting your attrition rate. 

  1. Lack of Anchors: Consider the patient’s relationship to you, your team and your practice as anchors that tie them to your practice and keep them coming back for more.  To you, the team, to something keeping them coming to your practice.  When we drop the ball on creating that relationship in any of these categories, we’re now more likely to lose this person as our patient.
  2. Convenience: With the success and popularity of companies like Amazon, Uber, Instacart, DoorDash and others, it’s clear that we’re in an age of Convenience.  A time when the average patient now values time over money.  If you haven’t stopped to ask yourself how you can make a visit to your office more convenient for the patient, then you’re missing out on a big reason why people chose to go elsewhere.    Instead of forcing patients to make an appointment by calling your office, why not let them choose the way they prefer?  Offering multiple ways to communicate that desire for an appointment whether it’s using your online scheduling portal, web chat or texting the office directly.  The more convenient we make the act of making an appointment, the more likely patients will be to continue scheduling. 
  3. Lost their dental insurance: In my book, How to Grow Your Dental Membership Plan I discuss the power and psychology behind the membership mindset.  Showing numerous examples of programs that have created the best customer loyalty, have used a membership plan as an additional anchor to keep them coming back for more.  In the dental world, there is no difference.

In today’s society it’s so engrained in our culture that you must have insurance to go visit a doctor or Dentist.  Yet every year the number of people who retain dental insurance keeps going down and down.  In one nationwide study, over 40% of those surveyed stated that they had not been to a dentist for any reason within the last 5 years. 

So how many patients are you loosing every month because they have now lost their dental insurance? The good news is that by creating your own dental membership plan and promoting this fact to those patients who are overdue in hygiene from 1 month to 24 months, you’ll actually be able to reactivate a great number of them.  At the same time, getting your noninsurance patients on your plan while transitioning your insurance patients onto your plan will help you reduce your attrition rate at its source. 

Add it up and that means your overall attrition rate goes down and the number of new patients, and thus money you need to invest to attract them, will be significantly reduced.  Allowing you an opportunity to rapidly grow your practice and profitability. 

By focusing my efforts on finding ways for my team to answer and schedule more new patient calls while getting better commitments from them to decrease no shows, I was automatically in a better position to save on marketing expense.  In fact, I was able to decrease my marketing expenditure from $36,000+/month to less than $10,000/month.  All while increasing my fee for service patient count from 60/month to averaging over 300/month. 

By leveraging the science of influence and persuasion to increase case acceptance and utilizing the psychology and benefits of a dental membership plan, we saw our revenue grow over $1,000,000 per year at each of my two offices.  Two years in a row.  The good news is that if you take time and effort to create work arounds and find solutions for the inefficiencies you currently face in each of the dental marketing cycles, you too will reap the fruits of your labor.  

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