A Metrics-Based Approach to Gauging Dental Patient Loyalty

Dental patient Loyalty

By: Trude Henderson

In his “Why you have fewer loyal patients than you think, and what to do about it,” published in Dentistry IQ on June 30, Steve Klinghoffer addresses the problem of patient retention. He begins by saying that every dental practice has three kinds of patients:

  1. “Raving fans.” This is self-explanatory.
  2. “Attendees.” These are patients who have been with a dental practice for years, but come only sporadically and don’t provide referrals.
  3. ‘Vulnerable Patients.” These visit only when there is a problem and often miss their appointments. And they might readily switch to another dental practice.
Klinghoffer points to a study conducted by Sally McKenzie, a dental educational and management consultant, which showed that 70% of new patients to a practice won’t return.

What to do? Klinghoffer says that the dental practice leader must strive to build a patient base comprised of raving fans – people who will keep coming back, comply with treatment recommendations and praise the practice in face-to-face encounters, on social media and/or on online dental review sites. The good news, he adds, is that you, the practice leader, can build a more stable customer base, and that you can start with the one you have now. (We should note that specialty practices such as orthodontics, for example, lose patients after they complete treatment, so family retention becomes more important.)

How can you best gauge the loyalty of your patient base? Klinghoffer suggests starting with some statistics:
  1. Your practice attrition rate. On the average, because of patients moving elsewhere, dying and switching insurance, a practice will lose between 10% to 17% of its patients via normal attrition. Klinghoffer gives the following example: “If you have 1,000 active patients and a 15% attrition rate and you’re not working to grow your practice, you’ll have 850 active patients by the end of a year,” and concludes that if a practice has an attrition rate exceeding 17%, it doesn’t have enough loyal patients.
  2. Your dental referral ratio. Klinghoffer says that a dental practice can feel comfortable with a range of 75%-80% of new patients gleaned from patient referrals. Our pilot study revealed that achieving this number can be a constant struggle, even in some of the most high-performing offices. However, the offices that had the highest and most consistent referral ratios had an e-survey customer feedback process in place and a supervisor who monitored the feedback in real-time. In addition, they engaged employees with on-the-spot coaching that included rewards for ideal behavior appropriate for the individual, rather than waiting for the occasional conference room or staff meeting. Daily huddles that included discussing details about the customer experience also played a major role in achieving more referrals, higher social media ratings and a better overall brand.
  3. Your conversion ratio. Action changes thingsKlinghoffer believes that patients you obtain via referrals “are already on the inside track” and will be more likely to, comply with treatment than those acquired via direct mail, online marketing or some other technique. We agree, having discovered that referrals are more likely to improve your conversion ratio, especially if you prioritize the ones who meet your criteria for beginning immediate treatment. For example, if your orthodontic practice requires a 6-month hygiene visit with no outstanding dental work before starting treatment, and your patient meets these criteria, then we recommend giving them a priority appointment over another patient who does not meet your criteria. Furthermore, telling the patient that you are giving him/her a priority appointment makes him/her feel special (because they are) and therefore, less likely to miss the appointment. These ‘high-value’ patients, (the definition depends on your practice’s business goals, but can include patients who are loyal, compliant with treatment, frequent- referrers and social media reviewers, cash-paying and ones who accept premium treatment options) can be very valuable to your practice. Perhaps these patients feel more confident as well as obligated to comply with treatment, so as to avoid letting their referrer down. We recommend targeting a conversion ratio of 75%-80%. You can calculate your conversion ratio by dividing the number of patients that accept your treatment by the number of new patients (foot traffic), and then multiplying that number by 100. For example, if you have 50 patients who accept treatment out of 100 new patients, your conversion ratio will be 50%. Please Note: Don’t be discouraged if your conversion ratio is not as high as you might have hoped. Rather, you should strive to keep the metrics fresh in the minds of staff and doctors, continue to ask “why” and to solicit suggestions from them – and then, take action! The simple fact that you listened will thrill your staff and doctors, and you yourself will be surprised at how quickly this approach can disrupt the status quo.

Klinghoffer suggests looking to your data for answers. With the right systems in place, you can count on abundant referrals, a low attrition rate and a willingness on the part of patients to abide by your treatment recommendations. We agree, and would add that transparency is invaluable to a practice, as long as its leaders draw on the insights gained to develop systems that foster continuous learning, mindfulness and accountability.  We wholeheartedly believe that practice leaders must continuously strive to align correct principles (defined by bestselling author Stephen R. Covey as “natural laws that are universally understood”) and practice systems, if they wish to engender a more predictable culture capable of building and sustaining a stable patient base (Shingo Institute, 2017).

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