Why Patients Leave and Don’t Come Back
I had a long discussion with The Boss this week about why patients leave and don’t come back, and I think he finally “got it”, but time will tell. Over the last two years I have noticed a steady increase in the number of existing patients who I have had to Archive or put into the Inactive files, and The Boss was none too happy about it.
Fortunately I keep very good records and notes any time I archive a patient or an entire family, and doing so helped reduce the angry tone in his voice when he asked me, “Why isn’t the schedule being kept as full as it used to be?!”
I had to explain to the good doctor that patients haven’t been coming in for treatments, or for their 6-month checkup’s for several reasons, and some of those reasons we have no control over. His question is a valid one and I don’t fault him for wondering or asking me about it since I’m the one responsible for keeping the schedule full of patients. I am not a magician and I cannot pull patients out of a hat and make them suddenly appear in our office to get their teeth cleaned or complete any other treatments. While the Hygienist’s schedule remains full at all times, there have been days where The Boss has zero patients scheduled for anything, and it bothers me just as much as it bothers him.
Why Patients Leave and Don’t Come Back
The number one reason patients leave and don’t come back is because they have moved away, with the majority of them moving to another state in order to have a job. Many of our previous patients worked for a large local corporation that completely dissolved, with thousands of workers being let go and desperately seeking another job wherever they could find one. Patient after patient called to ask if we knew a good dentist in their new location, or if we had recommendations on how to find a good dentist, since they hadn’t the chance to get to know very many people yet.
The number two reason for patients leaving is because we don’t offer what they want. Patients have heard all the buzz on the radio and television about Invisalign, one-day restorations with the CERAC machines, ZOOM whitening, etc. We don’t do root canals anymore, nor do we perform even a simple extraction, but patients are referred out for these treatments. Some patients have complained that we don’t offer these treatments anymore, and have elected to begin seeing a dentist that provides all of these treatments and more, all in one central location. We’re left with doing teeth cleanings, fillings, crowns, veneers, dentures and partials, and the occasional teeth whitening home-care kit using the Opalescence bleaching system.
The third reason is because patients have no idea what all we do, and what cosmetic choices they have available to them to enhance their smile. Some patients have come in for their regular checkup, and we’ve discovered they had gotten anterior veneers done at another dental office saying, “I didn’t know you do veneers”. Patients sometimes will call and talk to me about how they aren’t happy with having discolored teeth, and when I’ve suggested teeth whitening or even coming in for a consultation to discuss veneers, The Boss gets upset at me because he “doesn’t like” the patient and would prefer they go elsewhere. This week we had a patient who was getting his teeth cleaned and the Hygienist determined three old crowns needed to be redone due to recurrent decay, and The Boss got mad because he doesn’t want to do the crowns. The patient was referred to a Prosthodontist instead. Sigh…
Here I am doing everything within my power to bring patients in, fill the schedule and increase production, and he’s going to get mad at me because there’s a personality clash? Damned if I do, and damned if I don’t. What good does it do me to keep up with the latest dental technology and advancements, regularly reading dental magazines, taking hours upon hours of continuing ed courses in order to stay on top of everything going on in the dental industry, only to have The Boss shoot down everything I try to do for his office?! To say that I’ve grown disillusioned with my job is an enormous understatement.
The fourth reason patients have left is because their insurance changed and we don’t take it. Some patients have chosen an insurance plan that requires them to see a contracted In-Network dentist on their list, and if they were to see a dentist not found on the list, they are not given any benefits whatsoever or benefits are greatly reduced to the point where treatments are not financially possible for patients. This hasn’t been a problem for the majority of our patients, but it has put a real dent into our existing patient database, as I’ve had to archive those patients who left due to insurance reasons.
The fifth reason patients have left, and I believe this is the most important one, is that patients don’t think we care about them. Some of our existing patients have been with us since The Boss’ father was in practice, and chose to stay with us when he retired back in the late 80’s. The problem is, many of these patients are now elderly and their health has declined to the point where they are unable to come in on a regular basis anymore. Several of our elderly patients have passed away over the last year or two, but the great majority of existing and new patients are much younger.
One of the things that I always admired about The Boss when I first began working for him nearly twenty years ago, was how the dental practice felt like a big family. Whenever we’d be working on a male patient, there were always general discussions about sports, fishing and hunting, and that sort of conversation. The ladies would discuss their children or grandchildren, what was going on in the political arena, but things have changed where these discussions aren’t happening so much anymore. The Boss tends to focus more attention now on the clinical aspect of treatment and getting the job done, rather than spending those extra few moments to really connect with the patient on a more personal level.
I’ve begun to wonder if The Boss has lost much of his passion for his own career, which has subsequently rubbed off on me to where I now dread going to work each day. What used to be fun and challenging has morphed into monotony, and I truly believe I could do much of my job blindfolded. The Boss claims he doesn’t have interest in retiring for another ten years, but from what I’m seeing going on in our office, I’m thinking that his retirement may happen much sooner than that.
How is the Boss’s personal life? I find that there are 2 huge things that alter a dentist’s enthusiasm for practice.
1. Happiness at home directly relates to happiness within the work environment. A happy boss leads to happy staff.
2. Physical inability…things like Carpel Tunnel Syndrome.
You’ve been in the field for a long time. I’m glad I met you (albeit online) before you left — assuming that you do make that decision final. I likely wouldn’t have had the benefit of your wisdom otherwise.
Hi P,
Actually, he’s been happily divorced for about ten years or so, and spends a lot of time fishing, hunting, making his own fishing poles and just doing whatever he feels like.
He’s not dating, doesn’t claim to be lonely or in search for “someone special” etc. Having been with him for so long, and he walked down the aisle when I got married 5 years ago, we have conversations like friends do.
But then again, there is a fine line between being friends/friendly at work and separating the boss/employee relationship.
When he doesn’t have very many (or any) patients scheduled for himself, he becomes antsy with nothing to do but read his dental magazines, or jump online and doodle on a fishing site/forum.
He sees me on the phone all the time, calling patients, trying my darndest to get them scheduled. I confirm patients the day prior of course, but when patients don’t show up, it’s my fault. Argh! Me thinks he should hire on a limo service.
What is his definition of retirement? Hiring an associate and slowing down to 1 or 2 days a week, or getting out of dentistry altogether?
I’ve heard him talking to a couple different patients about when he plans to retire (quit dentistry altogether), and he said ten years. He’s 56 now, so…I’m guessing 9 nine years, IF THAT.
Currently we only work a 4-day week, Tuesday-Friday, and off on Mondays. With the way it’s been going, and the stress I feel and disillusionment, I’m working very hard towards leaving my job and doing something entirely different.
It would be a shame if you left the profession - please reconsider this! Your boss sounds restless and bored with the profession. I’m concerned though that your hygienist is recommending treatment and he doesn’t want to do it bcs of how he feels about the patient. That’s just not right - we have tons of patients we really don’t like
but they get care.
It’s been slow in our area too - funny though, my friend in Colorado says her office has been slammed. We’re rethinking our marketing efforts to get more people in the door. Perhaps your doc needs to take advantage of this slow time and take some online CE?
Hi Teresa, thanks for dropping in! I have also noticed that other dental offices have had some slow days, so I’m sure that is part of the problem.
The Boss takes lots of CE classes, many more than is required, and reads every single dental magazine known to man including technical/clinical magazines, along with a few that deal with practice management issues.
I’ve tried (as has the Hygienist) to persuade The Boss to take some general CE courses along with us that are more in line with the so-called “bed side manner” of dentistry. Some days he’s his normal self, talking and joking with patients and staff, while other days he’s an ol’ fuddy-duddy.
All I know at this point is that I’m not willing to wait around and watch the practice fall into the abyss. I’ve gotten to know many of our patients on a more personal level, and I can’t stand back and watch things go downhill as they are and have been.
I’ve been feeling this “itch” to leave for some time now, and begin doing something completely outside of dentistry, perhaps caring for local elderly men and women in a variety of ways. Providing transportation to and from the store, doctors appts, even light housekeeping, preparing simple meals etc.
I’m really fed up with my job. While I’ve written about how thoughtful The Boss is over the holidays, Dental Assistant’s Day etc, none of those accolades make up for all the other days throughout the year where I’m damned if I do and damned if I don’t.
Da,
What your boss needs is a new bright red Ferrari and a 22 year old girlfriend and all of your problems will be solved.
Remember….Life is not a dress rehearsal…if you are truly unhappy…make the change, go do something you enjoy.
Good Luck
DI
Hi D.I.,
He actually has a bright and shiny Corvette that he occasionally takes out for a spin. He’s lacking the girlfriend though, and claims he’s not at all interested in dating at this point.
I really am unhappy there, fed up and bored to tears. I really meant it when I said I could do my job blind-folded. It’s not as if there are any job promotions available for what I do. I do the same thing day in and day out, and I’m bored with it since I’ve been doing it on a daily basis for 20 years.
I am actively looking to make a change, and even though it may take a couple months to accomplish, I am so outta there.
One important reason people stop going to a certain dentist office—TRUST!
I was taking my family to a local dentist office that had a big neon sign that said “We cater to cowards!” I was there to get a tooth extracted and my daughter was getting a cleaning. The dentist told me to “raise my arm if it started to hurt” while he was doing the extraction. While he was doing it, it started to hurt A LOT! I raised my arm thinking he would stop, but he continued on for several seconds until the tooth was extracted. Right then and there I decided that would be the last time my family or I would ever step foot in that office again. I collected my daughter and got out of there as fast as possible and have not been back since.
If the dentist had said “This is going to hurt but I will try to get it over with as quickly as possible, that would have been fine. As soon as he did not do as promised, stopping if I raised my arm, all trust in him and his office went out the window.
Hi Bill, your complaint is one I’ve heard numerous times from other people (not our patients though). It makes me a bit nervous and uncomfortable when I hear or read the claim “painless dentistry”, or promises like “you won’t feel a thing”, because well……that’s not exactly correct.
The “raising your left hand” thing has been used in dental offices for many years as a way of letting the doctor and/or assistant know you need treatment to STOP for one reason or another. Some patients may raise their hand to signal they’re about to cough or sneeze, while others raise their hand in order to let the doctor know something or ask a question.
In our office, The Boss wears “magnifier glasses” which enlarges and focuses in on the area he’s looking at. Anytime a patient ever raises their hand I react immediately to that and let the doctor know because I realize The Boss can’t see their raised hand but I can.
I believe the dentist you saw should have been more clear about the likelihood that you will feel “something”, whether it be feeling pressure while he’s doing the extraction or some level of “pain” that might indicate the need for more anesthesia etc. I’m sorry you had a bad experience with that dentist, and I hope for you and your family that you’ll find a dentist that you feel comfortable with. That makes all the difference in the world. Good luck!