I was recently invited by Wendy Briggs and John Meis to present in Salt Lake City at the Team Training Institute about strategies for patient retention.  Here is a summary of that presentation…. 

Your ability to build a base of loyal patients means the difference between a good practice and a great one.  To underscore the importance of patient retention, let’s review some facts:

• It costs 6 to 7 times more to get a new patient than retain an existing patient (Source: Bain & Company)

• The true cost of losing a patient is higher than you might think.  It’s (Marketing Cost to Get a New Patient) + (Marketing Cost to Replace the Lost New Patient) + (Lost Value of Cleanings and Treatment the Patient Would Have Done for the Next 5 to 10 Years)

• Loyal patients are better than new patients, because 56% would never consider switching to another provider, 69% will return over and over indefinitely, and 78% will tell a friend or family member about you. (Source: Clickbank)

Clearly retention and loyalty are important, however, there is no silver bullet or one-time solution.  As Aristotle said, “We are what we repeatedly do.  Excellence, then, is not an act, but a habit.  

Here are three habits to build into your practice to give yourself the best possible chance of a high patient retention rate. 

Strategy 1: Exceed Patient Expectations.  
Go From Being “A” Dentist to “My” Dentist

While studying Economics at the University of Utah, my thesis focused on the question, “Do students who pay for their education value it more than students who do not?”  The data analysis showed that students who paid their way were more likely to place a higher value on their education than those who had their way paid by scholarships or family money. 

The background research for this paper included a lot of research into what causes people to be satisfied or dissatisfied with their purchases. 

The key is expectations.  Here are two examples that illustrate how critical expectations are in patient satisfaction. 

Expectations Loser:  
Home Remodel… "Over Promise, Under Deliver"

My family recently moved into a fixer-upper.  Our contractor swore up and down that they would have the renovations done in time for us to move in.  If you’ve ever remodeled your home, you know what’s coming next…

The contractor had over promised and under delivered.  

As we pulled up in the moving truck to unload on a snowy Saturday morning, I couldn’t believe my eyes when I saw a line of workers’ trucks parked at our house!  We had to dump all of our stuff into one room of the house because the remodelers were still laying down hardwood floors. 

It took a full month after that point to get the rest of the project done.  Our custom vanity was a month late.  We had gaping holes in our walls for weeks.  And every time something seemed to be done, we ended up dragging the contractors back to fix some loose end. 

Needless to say, because our actual experience was dramatically worse than the expectations set by the contractor, our satisfaction was VERY low. 

When neighbors asked us for our contractor’s name, do you think we gave it to them?  No, we told them to steer clear!

Expectations Winner:
Car Insurance Agent… Over Deliver in a Key Area

Contrast my renovations experience with my favorite car insurance company.  

Favorite car insurance company, you ask?  Is that possible?

Yes, I am fiercely loyal to Bear River Mutual auto insurance, and it all comes down to the fact that they blew my expectations out of the water two separate times. 

First, they are way less expensive than any other auto insurance company.  They are able to offer lower rates because in order to purchase from them you have to sign a contract that says that you don’t drink alcohol.  

Second, when you tell a friend about their services, they always make saying “thank you for the referral” a big deal.  When we referred my best friend to Bear River, they actually sent us a package of gourmet chocolates in the mail!

When’s the last time your car insurance company sent you a package of quality chocolate in the mail?

Going in to my experience with Bear River, I expected high prices and to be treated like just another insect paying monthly premiums the way I had been treated at previous auto insurers. 

Because Bear River exceeded my “how a car insurance company will treat me” expectations, I was HIGHLY satisfied with them, which led to my repeat business and referrals. 

The sad ending to the story is that Bear River doesn’t do business in Texas, so when I moved, I was forced to switch to the evil gecko at much higher rates. 

Are You Exceeding Patient Expectations? 

Let’s turn our attention away from home renovations and car insurance and back to dentistry.  Your new patients walk in your door with a host of expectations.  Some of these might include:

•    Wait times
•    Pain
•    How the staff will treat them
•    How dentists will treat them
•    Cleanliness of the office
•    What treatments a dentist has available
•    Cost of treatment
•    What insurance will cover
•    What treatment they suspect they need

Each patient interaction with your office is measured based off what the patient was expecting.  That includes every website click, phone call, and visit. 

If the experience you provide doesn’t measure up to patient expectations, they become unhappy “detractors” who are at risk of spreading negative word of mouth and defecting to another dentist. 

If the experience you provide is exactly what the patient was expecting, they are satisfied but unenthusiastic “passives,” likely to stick around unless a better option comes around. 

But if the experience you provide exceeds what the patient was expecting, they are very satisfied “promoters,” and they are likely to return, refer, and accept what is presented to them. 

How to Measure Your Ability to Exceed Patient Expectations

One common method used by large and small companies to measure patient satisfaction is called the Net Promoter Score (http://www.netpromoter.com/why-net-promoter/know).

Have each patient complete a simple survey question:  

1. “On a scale of 0 – 10 with 10 being highest, how likely is it that you would recommend [your practice] to a friend or colleague?”

If the patient answers 9 or 10, they are Promoters.  If they answer with a 7 or 8, they are Passives.  And if they answer 0 to 6, they are Detractors.  

The Net Promoter Score is the percentage of patients who are Promoters minus the percentage of patients who are Detractors. 

For example, with 76% Promoters, and only 8% Detractors, Southwest leads the airline industry with a total NPS of 68%.   

Customers purchasing health insurance are much harder to please; Kaiser leads its peers with a total NPS score of 35%.

Improving Your Patient Satisfaction

Trying to exceed all of your patient expectations all at the same time would be overwhelming, so a better strategy would be to select 1 or 2 key areas that are most important to your patients and focus on those first. 

To identify what expectations are most important to your patients, you might consider adding another 2 questions to your patient survey to get that patient satisfaction higher.  Combined with the previous question, this 3-question survey should take patients no more than 5 minutes. 

2. Why did you give us that score?
3. What can we do to earn a 10?

Here are some examples of how successful practices have used this strategy by choosing one key expectation important to their patient, and then blowing that expectation away. 

Case Study 1: A Unique Medicaid Experience 

Because not every practice is designed to accept Medicaid, Medicaid practices are sometimes the opposite of “high end.”  Rodeo Dental in Texas has flipped that expectation upside down by providing a wonderland for kids.  Their model has been successful. 

Case Study 2: A Dentist is a Dentist… Right?

Many patients assume that one dentist is as good as any dentist.  When you walk into Dr. Steve Titensor or Dr. Paul Koch’s office, you can’t help but notice the “wall of fame” featuring endless certificates, diplomas, and continuing education certifications.  The message is clear… this isn’t a run of the mill dentist you are dealing with.  By exceeding expectations about education and training, both of these practices have positioned themselves as the experts in their market, and successfully attract large cases on a regular basis. 

Case Study 3: Hours of Operation

Patients typically expect the dentist to be open from 8 am to 4 pm or so Monday through Thursday.  The McKinney Dentist prides itself on being open from 7 am to 5 pm Monday through Saturday.   This strategy has certainly contributed to this practice being one of the largest practices in the country. 

Case Study 4: Warranty

When it comes to your restorative and cosmetic work, we know that patients typically expect either no warranty, a lifetime warranty, or a warranty of a few months or so.   Dental Warranty client practices blow this expectation out of the water by offering 5-year coverage that follows the patient no matter where they go, including if they move or are travelling and have a problem.  This strategy contributes thousands to collections each year, and increases patient satisfaction.  Loyalty is also improved when the expectation is set that the patient must return for continuing care in order to keep the coverage active. 

So What?  Action Item #1

Keeping your market (the local area you serve) in mind, here are some questions to get you thinking…

1)    In what areas are you currently exceeding patient expectations?

2)    What expectations are important to your patients but aren’t currently being met by other dentists in your market?

3)    What expectations are most important to your patients?  How do you know?

4)     In what areas would you like to better exceed patient expectations?

Read Part 2 of this article, and please feel free to reach out to our team at Dental Warranty for more ideas about how you can use a warranty to grow your patient satisfaction and retention.