Last updated on June 6th, 2023 at 02:48 pm

Is your dental practice not growing as quickly as you think it should?

If so, there’s a good chance this lack of growth has more to do with patient attrition and failures in your hygiene department than it does with your new patient marketing.

As I mentioned in last week’s article, I’ve lectured to and met with thousands of dentists for the past seven years across the US and Canada. In many of the meetings/practice assessments I’ve done with doctors I place a strong focus on the doctor’s total patient count and patient attrition rate.

Many of these doctors see 20-25 new patients per month. Some see upwards of 50 per month, but in the vast majority of cases, their hygiene department has seen little to no growth. Well over 90% haven’t added a single day of hygiene in the past year.

(Related: Jumpstart Your Hygiene Department)

What that means is that for every new patient that came in the front door, a patient of record went out the back. With that in mind and the potential acquisition cost for a new patient ranging from upwards of $250, I think it’s important to calculate your attrition rate and figure out how to “plug the leak” in your patient base!

Calculating Your Patient Attrition Rate

MGE Management Experts - Dental Marketing CostsThe first step is to generate a report from your practice management software of every patient seen in the last five years (again, last week’s article covers how to do this and why we’re not using the “active” patient count).

Now there are a few things you can look at here:

  • Compare the total number of unique patients seen over that 5 year time period and compare it to your active patient count. For example, if your total patient count over 5 years is 3,000, but your active patient count is only 1,200, you can see how many patients you’re losing.By the way, if you really want to be aggressive with these numbers, I like to also compare with the number of patients seen within the last 6 months – because this tells you how many patients are actually following through with the recall schedule. A patient that hasn’t been in for 18 months may be “active,” in your software but they aren’t being retained in hygiene.
  • Take a look at your new patient numbers. If you’re seeing 25 new patients per month, that’s 300 new patients per year. That means you should be adding at least one additional day per week of hygiene each year (even if we account for a 40% attrition rate) just from new patient growth alone. So, if you’ve had the same number of hygienists working the same number of days for years… you’re losing just as many patients as you’re gaining.

And This is why Hygiene Department Growth Fails

So, we stagnate, and we think we’re not busy and we always need more new patients… but that’s just not true. Sure, you should always get a healthy number of new patients – but for growth, you need to place a similar focus on keeping the ones you have!

(Related: 6 Steps to a Productive Hygiene Department)

If you start to look at those differences between your total charts 5 years ago, 3 years ago, etc., and also calculate how many new patients you got, you’ll start to see how many patients just didn’t come back.

Why didn’t those patients come back? There are a lot of reasons for that, but the most common reason I find is that most practices are just satisfied that Hygiene is full. They think, “We have a full-time hygienist and she’s here four days a week – we’re full and always have been full.” And that’s a good thing!

But actually, it means we’ve ignored the attrition rate and are not reaching our practice’s potential.

Don’t be depressed about these numbers – be excited!

When we see how many patients we’re losing, it can be kind of a punch in the gut. It’s a little depressing.

(Related: 9 Ways to Fill Last-Minute Hygiene Openings)

But actually, if you find that you have way too many inactive patients out there – that’s a great thing! It means there’s a simple fix to increasing practice production and building your Hygiene Department.

One of the best source of “new patients” are inactive patients who haven’t been in for a while! These can be even better at times than a new patient because they already know you, you know them, and probably 60% of them have outstanding treatment!

So, what has to happen?

Step one: Start reactivating these patients!

You should be attempting to reactivate them by contacting them, marketing to them, sending them information and not forgetting about them. The more times you’re in front of those patients, the more likely it is that they come in.

(Related: Patient Reactivation: How to Successfully Get Overdue Patients Back on the Hygiene Schedule)

More than once in our practice, we could have sworn that a patient moved away or went to another office because they haven’t been in to see us for five years. But then one day they call to make an appointment. We, of course, ask (politely) “Did you get our emails? Phone calls? Letters?” And they say, “Yes, I did!” And we would say, “Well, okay, how come you didn’t give us a call?” And they’d say, “Well, nothing hurt, I was busy, life got crazy, etc.” From our end, we persisted, and it wasn’t until the 20th letter or call or email that they finally took notice and called to set an appointment!

So, keep reaching out to them, and eventually, they notice or have a reason to come in.

How do you do this effectively?

We have a simple, turn-key Reactivation Program that you can implement in your office. It’s been proven effective by thousands of dental offices that have used it. You can schedule a free consultation here and we’ll give you this program to you at no charge.

We also provide complete training for building a productive hygiene department and reactivating patients on our online training platform, DDS Success. On DDS Success, you can learn these systems and a lot more, and have your staff log in to do the training on it directly. Click here to do a free demo.


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