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30 Nov 2020 | Oral Hygiene

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A few words could double your income

By Dr Michael Sernik

Practice Management

At the end of the appointment, if you ask "Do you want to book your next 6-month appointment now?", you'll have some people say, "look, I'd like to check my schedule at work and I'll give you a call."

Once they say this, it's difficult to turn around.

Now here's an approach that will deliver predictable results:

State "I presume you don't know your schedule in 6 months from now".

They'll usually say something like, "That's right".

"Our forward bookings are already tight, so, if you like, I'll pencil you in the appointment book for now. You are not at all committed because I'll text you 2 weeks before and if you need to change the time, I can shuffle things around. Does that make sense?"

It's amazing how a very small shift in communications can have such a profound effect on practice success.

Did you know that your hygiene re-appointment rate is the highest correlating metric for overall practice income?

A US study showed that when practices went from a re-appointment rate of 60% to 95%, the entire practice income doubled. That's because the more people visiting your practice for hygiene - the more they refer new patients and the more likely they are to remain with you and the more likely they'll have the treatment that they might have been putting off.

Makes a lot of sense.

To ensure a stronger commitment, here's another idea.

I used to have a hygienist who had a habit of saying things like "You're doing very well. Let's see you in 6 months". To be honest, I never gave that comment a second thought. Then one day, it occurred to me that this message might be causing more harm than good. She was trying to provide the patient with some positive encouragement, which is to be commended, but maybe she was also removing a key driver in having the patient want to return.

People are more motivated by avoiding pain than seeking pleasure. The compliment was providing pleasure. Are they going to keep coming back to get compliments? Or do we want them to keep coming back to avoid pain?

So, we instituted a new protocol.

We decided she should always find something in the mouth - some area that was questionable; something that needed to be monitored. None of this was a fabrication. It wasn't hard to target one vulnerable area. It's just that she'd never thought of doing that. She needed to take a photo of that spot and draw the patient's attention to it. At the end of the appointment, she would now say something like "you're doing very well, but I'm very interested to see how you can manage this area we talked about. The concern I have is that if bacteria get in there and grow, they will cause the gum to become detached and then as that happens, more bacteria will breed in there. So, I'm sure you'll do a great job and I really look forward to our next appointment."

Then she gave them a copy of the photo... if it was worthwhile.

None of this was a script. The actual words used were always appropriate to the situation. We began monitoring how many people were seen for a recall within 7 months of their last appointment. The attendance rate went from around 60% to over 90%.

So, is it a mistake to encourage people? No, but it is a mistake to paint too rosy a picture for the patient. By accentuating the positive, you give the patient a false sense of security, which means they won't think it's important to come as regularly as we would like. However, if you tell the truth, that there are some suspect areas in their mouth that you'd like to keep an eye on to ensure nothing deteriorates, then you start to REALLY motivate your patients to do the right thing and come as often as you recommend.

Don't kill your patients (and your practice) with kindness. Tell them what's going on and get them motivated to come back.

The problem with measuring re-attendance rates is that you don't see results for many months. It dawned on me that it's much easier to measure the re-appointment rate daily. It takes less than 1 minute/day. On today's schedule, just add an asterisk or change the font colour on the day's patients who leave with a next appointment booked. That's easy. Then write the fraction: 12 (booked ahead)/15 (seen today).

At the end of the week, add all the numerators and all the denominators and display as a percentage for the week. Get a monthly report by averaging the 4 weekly percentages.

Like all communications training, you'll need to pay attention to the tonality and pace. Just giving your team a script won't work. It's best to schedule a practice session and practice every element. The longer someone's been doing it differently, the harder it is to de-progamme old habits.

Dr Michael Sernik is the creator of Channel D, dental videos designed to trigger conversations that will grow your practice. Visit and use Code MA56 to start your trial.

SernikSpeak is a new program offering online communications training for dental practices. If you're interested in finding out about the new SernikSpeak Communications program, just go to and register your interest.


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