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.
Tags: Basic Dental Care, Business Relationships, Communication, Continuing Ed, Dental Assisting, Dental Insurance, Dental Practice Management, Productivity, endodontics by D.A.
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