An article dated December 1st in the L.A. Times entitled: "Dentists Turn To Marketing After Getting The Brush-Off From Patients" details how dentists have struggled to adapt to the new, less prosperous, dental environment. In the article dentists are said to be spending more money on marketing, consultants, and seeking strategies that will return them to pre-meltdown profits. As a dental consultant I was surprised how accurate the article really was in light of it coming from outside the industry. He concludes by saying that patients have notably reduced their visits to the dentists, pointing out that patients are now saying "it's just a cleaning". This should be a wakeup call for all of us. It might be "just a cleaning" to the patient, but to the dental industry it's a matter of life and death. The lost restorative dentistry resulting from missed or non existent hygiene visits is potentially devastating.
What does it mean that dentists are turning to marketing, or to consultants? I'm always amazed that some doctors believe that their real problem is that their not spending enough on marketing. While it's true that some of the newer doctors or larger multi doctor offices are forced to commit a higher percentage of their gross to aggressive marketing, the normal solo operator affected by our current economic situation, will find an increased marketing budget to be a big disappointment. Is the real problem in dentistry the fact that all at once, patients just forgot about us? Did the economic downturn effect their ability to remember how great our office experience really is? Think about it, if our super satisfied patients are fading away because of our new economic reality, will advertising patients who have never met us like us any better? The forces driving our best patients away are the same ones that will make paid advertising that much more challenging.
When an office is really under the gun to advertise new patients into an office, one of the first things they learn is that advertising patients are more challenging to work with. Add to this idea that a slew of marketing patients are going to start filling the few ops you already have with visits that produce restorative dentistry about half the time. I don't mention these things prove dental marketing a bad idea, just to point out that fixing our current state of economic-driven practice erosion with marginally cost effective marketing patients is going to be a disappointment for most docs who go this route.
So, what is the answer to current economic conditions? This situation is like draining a lake, you find all sorts of things that probably don't really belong there. In dentistry, you drain the economy and you find prices, policies and practices that really were supported by a booming economy or generous insurance benefits. Let me give you a great example of some of the things we find when we tear a practice apart looking for the cause of lost production.
"Piling On". When you tell a patient that a cleaning is $97, this done in an effort to get them in the door, then start piling on lots of small charges. I'm talking about everything from rinses to periodic exams, to an arm load of removable appliances. Much of this pile-on selling is commissioned, so no patient is left undamaged. Commission seeking hygienist are very thorough, every patient is pitched for ad-ons. Not all hygienist fall into this category but it's a good idea to recheck and make sure I didn't just describe your office.
Not only is it interesting to see how many $97 cleanings turn out to cost $250, but to find that doctors themselves don't accept the reality of their own fees. When asked directly what a new patient will pay on their first visit, the average dentists will quote number that is far below the amount the patient will be asked to pay. Typically, the conversation goes like this, "So, how much does a patient pay on their first visit"? The doctor responds by listing all their charges, avoiding the total, because they know it will sound too high. In other words, they won't even admit to themselves what their patients are being asked to pay. This may have worked when everyone's house doubled in price every 4 years. Today, it's the formula for slowly dissolving your practice, and no amount of marketing is going to fix it. Some doctors fear backing off on the "pile on" strategy for fear they'll see their bottom line reduced. In the short run this may indeed be the case. In the long run...well, there won't be a long run for doctors who believe that secretly piling on fees for itemized services will fool the patients into continuing pay more for treatment than feels comfortable.
So, am I telling you to cut your fees? Personally, I believe that's the last place to go when it comes to making major practice changes. I do think it's time to look at what we're selling to patients. For those patients who fear they may not have a job next week, lets make sure they have all of their essential restorative dental needs met before we systematically shake them down for everything a patient could possibly need done to their mouths. Of course you don't want to overlook or under play their true clinical needs, but stay with a treatment sequence that fits each patients financial capabilities. Be very aware of who's pushing what in the practice. Too many doctors are afraid to weigh in when a hygienist is hard-closing every patient on big soft tissue cases. The doctor fears that he/she will appear weak in the war on gum decease. It's almost as if the doctor stands by and watches his or her practice being destroyed by a morally superior hygienist.
Isn't it true that most of us fear the law of unintended consequences? If you make the practice more patient-friendly and more in tune with the current economy, will it ultimately be your undoing? The answer to that question is simply NO, staying on the course that's hollowing out your practice will be your undoing. You don't have to make all these changes overnight, just start looking at the practice from the standpoint of how you can make the treatment more affordable, more in line with the patient's priorities, and less from the viewpoint of "what else can we sell these people". No doubt, in the end it means we're going to have to see more patients and make them even happier than they are now, no easy job, but that's the challenge of our times, not simply buying more Facebook ads.
