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Published by Viva Concepts, 2018-08-23 10:40:39

Hygiene Residual Course


The Masters of Marketing Administration is an educational advancement for training of business owners and their administrative and support staff on the Viva System—a system that puts in place the
ideal residual business model for consumer
acquisition, loyalty and retention.
Copyright © 2018 by Gregory Hughes, Viva Concepts, LLC. All rights reserved. This book or any portion thereof may not be reproduced or used in any manner whatsoever without the express written permission of the publisher except for the use of brief quotations in a book review. Printed in the United States of America. Second Printing, 2018.

Overview of the Viva System
Every business in existence operates on precise laws. The laws are the same in every business regardless of the type of business. A hair salon, Starbucks, Victoria Secrets, Macy's or a local donut shop all operate on the same laws. Knowing these laws will give greater understanding of the business side of the practice.
The 4 Business Laws:
1) 2) 3) 4)
Consumer Acquisition: Every business will always have to acquire new consumers to continue to expand. Why? Because existing consumers are lost every month from the company’s database.
Consumer Sales: Once a business acquires a consumer the business has to sell its service(s) or product(s).
Consumer Retention: Once the consumer has purchased something then that same consumer returns for future purchases or services. It means “keeping” the patient.
Positive Experience: Positive experience is powerful because referred patients cost virtually nothing to the practice owner while new patients acquired through marketing efforts usually cost around $300 per new patient.
1 ) Consumer Acquisition 3) Consumer Retention
2) Consumer Sales 4) Positive Experience

The Secret to Increasing Case Acceptance Growing the Active Patient Database
The most important aspect to improve case acceptance in any practice is through an understanding of the four business laws and how they interrelate. Specifically, when a patient enters a practice and receives his or her diagnosis, much of the diagnosed work is done at a future date due to patient limitation of finance, ceilings on their insurance, fear of doing the procedure and so on.
To fully grasp how the four business laws are interrelated let us cover some basic metrics (measurements) about the dental industry. The first metric, published by Dental IQ, the American Dental Association and Dental Economics, reveals the incomplete treatment in dental offices across the country averages 60-65%.
All of a sudden the importance of Consumer Retention becomes extremely important. There are several reasons for this:
1) Retention becomes a critical factor in raising case acceptance as the work is done in subsequent visits.
2) The patients, who are in a hygiene retention program where they visit twice a year for their cleanings and exams have a higher case completion because the education and dialogue from the dental staff gives them a greater understanding as to why they need to complete their treatment.
3) A patient is always more likely to accept treatment due to improved trust with the doctor and staff.
4) Returning patients improve consumer acquisition (lower case) as they are more likely to refer
their family and friends.

Growing the Active Patient Count
The diagram below illustrates what the four business laws accomplish. As seen by the arrows of each business law, the successful application of each law increases the size of the active patient database. The active database controls the growth of any business. Its long term increase in both the size of the business and the volume of its revenue.
Consumer Acquisition Consumer Retention
Consumer Sales (Case Acceptance)
Positive Experience

The Most Important Number
Active Patient Count: Why is there a Wrong Definition?
For educational purposes, an excerpt from an article published by Henry Schein is quoted below. The statement is replete throughout the industry and has left this subject in a confu- sion. Here is the excerpt:
“...there is variation between different consultants as to what period this active patient count should be—twelve, eighteen, or twenty-four months.
“We prefer eighteen months.
“Part of this variation i?s caused by limitations of various dental software programs. Many programs can only provide twelve or twenty-four month reports.” 1
”Less than 5% of all practicing general dentists know what their 'active patient count' is.”
Henry Schein Article, entitled, “ e Most Important Number— e Active Patient Count (see full article at end of this booklet)

The Active Patient Count
The CORRECT Definition:
The number of annual hygiene recall visits divided by 2.
This definition clearly shows the residual income component of your practice. Single appointments (such as emergencies), operative procedures and new patient procedures are the Linear Income component of your business.
A new patient for exam, x-rays and cleaning or operative or emergency do not count as an “active patient” and cannot be included in the active patient count. An active patient is a retention patient... a patient that is returning for a hygiene re-care or recall visit. Once a patient has returned for their first re-care visit, they enter into the retention category and are now included in the "active patient count" calculation.
Active Patient Count Definition:
This definition was chosen for simplicity of calculating.
If a patient is seen 1, 2, 3 or more times per year in the hygiene department, the number is still divided by 2. While this number is not “perfect,” patients with 3 or 4 appointments (perio patients) and patients with only 1 appointment will average out to give an very close active patient count. The Active Patient Count does not include new patient hygiene visits. New patients are not a recall visit and have not yet entered the retention category of the practice. These patients count upon their first recall visit.

Consumer Retention & Loyalty
Building Residual Income

The Hygiene Department
The industry of dentistry has been focused on building a practice through new patient acquisition. While acquiring new patients is and has always been a part of any business model, it has never been the most important component!
The Most Valuable Component
The most valuable component of any business is its existing clientele (patients). The busi- ness aspect of this is called RETENTION & LOYALTY. Retention, in the dental industry, is the only component that builds residual income.1
1 Residual Income: income that continues to be generated after the initial effort has been expended. Industry Mindset
The dental industry, consultants, marketing companies, website companies, major dental suppliers and the like have flooded the Internet with advertisements geared toward "I need new patients. I need new patients."
Of course every practice needs new patients. However, the existing patient charts is where most of the revenue is sitting in offices across the U.S. At best 35-40% of patient's treatment have been completed as according to the ADA over 60-65% of charts have incomplete treatment sitting in the charts.
Retention, Constant Contact & the Residual System
The value of an existing patient is rarely understood, yet businesses for a millennium have built empires by utilizing their existing consumers to generate word-of-mouth referrals. Your patient database is a marketing powerhouse that you can easily leverage to get more patients in the door and, since referred patients cost you next to nothing to acquire, you also reduce your overall cost of new patient acquisition.
The missing element is residual income. Viva has uncovered it!

Residual & Linear Income–Definitions
Residual Income Developes Exponentially over time.
Residual Income: income that continues to be generated after the initial effort has been expended (also called recurring income). For a dental practice, patients receiving their bi-annual hygiene visits would be contributing residual income to the practice.
Linear Income: is “one-shot” compensation or payment in the form of a fee, wage, or salary.” The majority of practices in the US operate off of this type of income.

Residual Hygiene Revenue Always Residual Hygiene Revenue Always
Outperforms Operative Revenue Out-performs Operative Revenue
With the Correct Retention System & Disciplines Residual Hygiene Revenue Always Grows With Time
Operative Dentistry from Doctor Always has a Revenue Ceiling
The reason for this is covered later on this course on page 21.
Examples of Linear versus Residual Income:
Linear: A patient comes in for an extraction and never returns. Residual: A patient coming in twice a year for re-care.
Linear: Buying an iphone for $800.
Residual: Paying $49/month to a service provider (i.e. AT&T) Linear: Selling a movie DVD for $15.
Residual: Netflix subscription for $12/month.
The Hygiene Department is the "spine of the practice" as the entire focus is on retaining patients which in turn is the focal point of retention and building a residual-based practice.

The Ideal Goal for Hygiene Dept The ideal goal or objective for any business is to generate a higher level of residual
income over linear income!
The Hygiene Department accomplishes this objective.
Annual Hygiene Department Revenue Growth
Year 1 Year 2 Year 3 Year 4 Year 5
Total Residual Income Increases Continuously Over TIME!
Linear income is the work-a-day world for 95% of general dentists.
Linear income is itself part of the working model for dentistry... but as you work and put in the time over the years, it is necessary to build your residual income and invest in your database to raise your hygiene residual income. The above graph illustrates how linear income goes to zero when
you stop working at any time. Residual income continues.
Years go by quickly and your most valuable asset in creating residual income is TIME.
Total Production $
Residual Income Linear Income
Residual Income Linear Income
Residual Income Linear Income
Residual Income Linear Income
Linear Income
Residual Income

d the dynamics and growth one has to understand the
ual Income.”
Exponential Benefits from Residual Income
The benefits or rewards from a residual Income based practice are far greater than imagined. Retention causes residual income and brings about numerous benefits including:
• Higher case acceptance due to patients coming back through routine hygiene visits
• Increased loyalty from patients
• Increased income from the hygiene revenue center
• Most importantly, an increase in word-of-mouth referrals is generated due to the increase in people coming in and out of the office.
• Less dependency on the owner/doctor being the primary provider for the office and working toward removing the hand cuffs from owner/doctor.
Increase Referrals
Hygiene Revenue
Higher Acceptance
Residual Case
More Free Time
Income Security
ncome is income that continues to be generated
n e
initial effort has been expended. Also called

The Single Largest Benefit
The single largest benefit of a residual income practice is removing the burden, stress and day to day "grind" of daily practice.
Every owner of a practice (who's the primary producer) has a pair of "silent handcuffs" attached to his business. It is much like having a rubber band attached to the owner. If he or she leaves the practice for any length of time, such as 5, 7, 14 days or longer, the following occurs: the longer he or she is out of the practice, the tighter the rubber band becomes. Why? The rubber band tightens due to financial obligations of the business.
The practice still needs to pay leases, rent, equipment payments, payroll and utilities; therefore, when the practice owner tries to take time off, the "rubber band" snaps him or her back into the practice. The Hygiene Department removes the handcuffs to a large degree and stabilizes the income at a far higher level.
As hygiene days are increased (more retention of patients) the annual revenue increases by $300,000 per year for every full time hygienist added.
Residual Income Continues
Dr. Stops Working
Income drops to zero
Total Income

Database Dynamics
Definition of Dynamics:
Dynamics are the forces or properties that stimulate growth, development, or change within a system or process.

The Largest Situation to
Long Term Practice Growth
The loss of the patients from your database is the largest situation to long term practice growth. The national average database metrics in the dental industry after 15 years of practice ranges between 800 - 950 active patients. Yet after 15 years of being in practice your database should have continued to grow, however it hits a ceiling (as shown in the diagram at the bottom of the page).
As there is no one single person held responsible for the function of retention: patients are not scheduled in advance; they cancel without reappointing; some move; and from general lack of contact or mailings to patients in the database, the result is over 90% loss and higher.
Database Leakage
National Average after 15yrs
650 - 800
200 - 300 450 - 550
650 - 800
800 - 950
700 - 850
0 5 10 15 20 25
Database Peaks Between 12 - 15 Years And Then Declines

ADA Surveys Show a Minimum of 35% - 45% of Your Practice Database is Lost Every Year.
60 - 65% of patient files in the dental industry have incomplete treatment.

Business Revenue Law:
The Number of Constant Contacts to the Database determines the revenue growth for any business.
$400,000 $600,000
Revenue growth is always proportionate

As the owner, your most critical statistic to keep, monitor and control is:
The Size of the Active Patient Count1
$900,000 $1,900,000
to the size of the Active Consumer Count
1 Active Patient Count is defined as the No. of Recall Visits per month, per quarter and per year divided by 2 (average patient receives 2 visits per year). The Active Patient Count does not include new patient hygiene visits. These hygiene visits only count when they arrive for a recall visit.

The Only Method to Increase The Active Database
One of the primary and most important aspects of any business is controlling the number of people that come into the organization on a daily, weekly and monthly basis. The financial volume and solvency of any organization depends on the number of people that come into the business.
If you look at any retail store, you can immediately see the importance of having a multitude of consumers regularly walking through the doors of the business. For example, let's say you walked into JC Penney's to buy shoes and noticed 20 - 25 people in your line of sight. Well, three weeks later you enter the same store but the number of people is dramatically increased as you can now visibly see 75 - 100 people in your line of sight. The financial volume will be far greater as the number of people in the business (on a daily, weekly and monthly basis) continues to increase.
Patients in the Practice
New Patients into the Practice
Patients leaking out the back-door

How to Calculate Number of Patients in the Practice
There are 3 ways to increase the Number of Patients in the Practice:
1. New Patients
2. Patients seen by the dentist for operative services 3. Hygiene recall patients
1. The Number of New Patients Per Month
What is the average # of new patients seen by most dental practices per month?
The patients (on a monthly basis) generated by the dentist hits a ceiling of 190 to 220! While he or she could "raise this statistic" through longer hours, the fact remains he or she cannot dramatically increase or raise this number—and herein lies the reason why the practice income hits a ceiling after a few years of practice!
The Active Database can Only be Increased by Increasing Hygiene Recall Visits
2. The Number of Operative Patients Treated Per Day by the Doctor?
What is the average # of operative patients seen per day by the doctor?
10 patients/day X 16 days/mo.
Total Patients in the Office from #1 and #2 = 190/mo.
There is a ceiling of approximately 190 to 220 patients (on a monthly basis) from a combination of new patients and patients seen by the dentist for operative services.
3. The Number of Hygiene Recall Visits per Day & per Month
What is the average # of patient recalls seen per day by the hygienists?
Hygienist #1 Hygienist #2
Hygienist #3 Hygienist #4
10 patients/day X
16 days/mo.

Hygiene Industry Metrics
In managing the hygiene center of any practice it is important to know the average metrics (or numbers) that the average hygienist across the country produces each day, month and year. With proper production figures one can then set up a hygiene center which delivers excellent patient care and provides substantial, residual profit for the practice.
The following charts below show the hygiene industry average days worked, patients seen per day as well as the average daily and annual revenue produced.
U.S. Average Annual Hygiene Metrics
1. Number of days the average hygienist works per week.
2. Number of weeks worked per year.
3. Total working days per year.
4. The average # of patients seen by dental hygienists per day.
5. Number of hygiene visits per year for a single hygienist.
U.S. Average Annual Hygiene Revenue
Average daily hygiene production per day.
4 50
200 8 1,600
Annual Revenue per Hygienist
Average Daily Production
Total Working Days/Year

Current Hygiene Revenue
Hygiene Days Per Week
Step 1: Write down number of days of hygiene currently in your practice. Enter this in the box provided.
Total Hygiene Days Per Year
Step 2: Multiply number of days of hygiene, from Step 1 above, by 50 working weeks/year. Enter this in the
box provided.
Calculate your current annual hygiene revenue by following the steps below
Total Hygiene Revenue Per Year
Step 3: Multiply the total yearly hygiene working days, from Step 2 above, by the average daily hygiene production in your office. If you don’t know the daily production amount, just give an estimate of
the average. Enter this in the box provided.
Average Production

What the Numbers Should Be
According to the ADA the national average for number of new patients per month is, 30.
30 patients/month X 12 Mo./Per year = 360 patients per year
Years in Practice
1 year
After 10 Years: 360/year X 10 years = 3,600 patients
10 years

The example below illustrates a national average in the dental industry. The numbers vary from practice to practice but it is easy to calculate a close estimate for any practice. By knowing the average number of new patients per month for the practice you currently work in, the number of patients seen in the practice over the time period of its existence can easily be estimated.
After 20 Years: 360/year X 20 years = 7,200 patients
20 years

Watch The Numbers
According to the American Dental Association, the average practice in the dental industry loses approximately 40% of its patient base each year. The average dental practice in the U.S. obtains 30 new patients per month. The below illustration shows the size of the patient base after 1 year, 10 years and 20 years. At 30 patients per month at the end of the first year the practice will have 360 patients (12 months x 30 patients per month).
The red outlined number represents a 40% loss of patients per year. The purpose of this illustration is to demonstrate the potential size of the database taking into account an average loss of 40%. This loss of 40% is an industry average metric for dental offices across the U.S.
This # represents a
40% loss of the database
Years in Practice
1 year
10 years

This # represents a
40% loss of the database
20 years

Calculating Your Potential
The illustration below uses an average practice after 10 years in business (taken from the previous page.) If the practice had retained 60% of its patient base (after 40% of the patient base is lost each year), there are2160patientsthatshouldstillremaininthedatabase. Eachofthepatientsshouldhaveanaverage of 2 hygiene visits per year (not counting perio patients), giving a total of 4,320 hygiene recall visits per year. Theremainingmathshowshowmanyhygieniststhepracticeshouldhaveafter10years(2.7full timehygienists). Thesenumbersareusedinthefollowingpagetoshowthepotentialhygienerevenue if the practice had retained its patients over time.
3600 =
40% loss of Patients in Database which leaves 60% retained as patients
4,320 Hygiene Appts
2160 Patients Should have been retained X 2 Hygiene Visits per year = 4,320 Hygiene Visits
10 Yrs

Retention & Loyalty Hygiene Industry Metrics
The Average Hygienist works 200 days/year. Hygienists Treat An Average of 8 Patients/day.
The Annual Patients Seen Per Year = 1600.
The Average Daily Hygiene Production = $1,500
4,320 Recall Patients/Yr
1600 is the average hygiene visits per year
2.7 full time hygienists
Annual Revenue for Hygiene Center
The average industry hygienist produces $300,000 per year. With 2.7 full time hygienist with each producing an average of $300,000 per year would generate $810,000 in annual hygiene revenue.

The Single Largest Situation
The single largest loss of practitioner’s long term income in the dental industry is database leakage. The dental industry is unaware and uneducated on the subject of consumer retention. As stated earlier in this book, the focus for practice growth is on obtaining new patients.
90% of Your New Patients
Are Lost Out the Back Door
Database Leakage

Calculating the Loss In Your Practice
1. How many days a week of hygiene does the practice currently have?
2. Multiply the # of days of hygiene X 8 patients per day. This will give you the average number of hygiene patients per week.
3. Using your calculation from step 2 above, multiply the # of hygiene patients per week X 50 weeks per year. Now divide this number by 2, as the average patient should be seen twice a year by the hygienist.
4. The number calculated in step 3 is very close to your active patient count.
5. How many years has the practice been in existence?
6. What is the average # of new patients per month in the practice?
Note: Use the average # of new patients for all years the practice has been open. Give an estimate to the best of your knowledge.
7. Multiply the # of new patients from step 6 X 12 months per year. This will give the annual number of new patients seen by the practice.
8. Take the number from step 7 and multiply it times the number of years the practice has been in existence.
9. Divide the number in step 4 by the number in step 8. This will give a percent of database patients lost since the practice has opened.

Stopping the Leakage From the Database
There has been no automated system for database retention and loyalty.
A thorough study of practice metrics (showing an excess of 90% loss of patients) led Viva to focus on database growth and the bolstering (increasing) of the patient retention by the Department of Hygiene.
Database Leakage
The most important dynamic of any
practice database is asking patients for
referrals. Throughout the history of the dental profession, the majority of practices have been built upon referrals.
To date, the full dynamics and system of leveraging patients for referrals has not been researched or published. The following pages give an insight to the power and impact of a business' database.
Marketing dollars for external marketing are costly and while necessary for any practice to grow, the vital element of any marketing is to keep and maintain patients through a retention program (also called a loyalty program). These patients can then be utilized to generate referrals. Again, referrals are the most inexpensive means of acquiring new patients.
To fully grasp the dynamics (or forces or properties that stimulate growth) let us see on the following pages what the database looks like in any neighborhood surrounding a practice.

Word of Mouth: On Steroids
The Care to Share gift box is called a Vivapak. It is the primary tool to assist patients to refer
their family and friends. Due to its uniqueness, the Vivapak can be passed on by your patient to someone they know. The beautiful pack has a long shelf-life and is not likely to be thrown out, and thus increasing the chance that the customer will pass it along.
Vivapak Closed
The Viva "Care to Share" Gift Pak
Vivapak Opened
The Best Method to Lower All Marketing Costs
The national average cost of obtaining a new patient is $250. As this is an average, your cost may be higher or lower. However, it’s a FACT that your cost of acquiring a patient is reduced by 1/2 by obtaining just 1 referral. If a 2nd generation referral is obtained then the cost of acquiring a patient drops to 1/3rd. As the referred patients don't cost the practice owner anything extra, then he or she has essentially gotten three patients for the price of one ($250 divided by 3 is roughly $83).
1st Generation 2nd Generation Referral Referral
$250 per Patient
$125 per Patient
$83 per Patient

Loyalty & Database Mailers

Creating a Continuous Loyalty
The most important aspect to stop the leakage and create a returning consumer for any business is to remain in constant contact with everyone who has come into the business. This was earlier covered but is being re-iterated and this is the "BUSINESS REVENUE LAW," which states:
The Number of Constant Contacts to the Database determines the revenue growth for any business.
This is a breakthrough in the dental industry. It is a hard-won concept that many large corporations have learned but relatively unknown to the world of dentistry
The Viva Inspiration Database Mailers
The Viva Database Mailers are called "Inspiration Mailers." They were researched and designed to give patients a "Gift of Inspiration." There are a total of 5 mailers done each year . They are send at precisely timed months during the year, about once per quarter. They are for the following occasions:
Branded Quarterly Database Mailer
• Happy Birthday
• Happy Holiday
• Happy New Year • Spring Occasion
• Summer Occasion
The "Gifts of Inspiration" are from national and internationally known iconic leaders, both men and women, who have inspired others towards their own goals or to help them overcome barriers that they too encountered.
As illustrated in the following representations, the database mailers give a "Gift of Inspiration" to patients...making the practice the "Inspirational Leader" to inspire people in the community.

Inspiring the Community Database Mailings
Mailed in a Clear-Windowed Envelope The above is a sample. Your database mailer will have its own design to match the
brand of your office.
The "Inspirational Message" of the Hygiene Department, in each mailing to the patient, is a message of "Wellness" to educate each patient to reduce and/or eliminate their dentistry for a lifetime! The above image llustrates one of the 5 annual mailings (Happy Birthday).
On the opposite page you can read an example of what the message is to the patient.
A continuous inspirational message creates loyalty and brings about a stronger relationship and bonding with patients to improve and grow the most important business law #3, which is Patient Retention!

The inside "insert" is a Hygiene Inspiration Message of the "Wellness Program" to come to their next hygiene visit & a Message to "Share it Forward" to family or friends.
• Happy Birthday
• Happy Holiday
• Happy New Year • Spring Occasion
• Summer Occasion
A Gift Card for the Patient at next visit
Dear Patient,
Wishing you the most wonderful day on your birthday!
In hopes of lifting your spirits and to quicken your step, we have included an inspirational quote for this special day.
Share it Forward to a family member or friend to spark their day!
Our continuing inspiration for you and those who surround you is to achieve the goal of “Wellness,” of never needing dentistry in the future.
Hope to see you soon at your next hygiene visit.
Our Kindest Regards, Your Dental Hygienist &
e b
k o
f t
e G
t C
d c
s a
a N
o refer a family member or friend. 37
w P
t S
l t

How it Works!
The Inspiration Mailers to patients improves not only the relationship to increase retention but it works to leverage your existing patients to refer their family and friends.
The power of any business' database is the largest asset the company has...the patients of record are literally the spine of the practice. Here is how it works.
The person happily reads the inspiration quote.
Your patient receives the Inspirational Gift Card.
The family member or friend arrives to the practice as a referral.
ABC Family Dental
The patient "Shares it Forward" to a family member or friend.
The person reads the invitation of the special offer to the practice.

Inspiration: Retention Mailers
As mentioned earlier, there are 5 database mailers each year. They are mailed once a quarter (seasonal) in alignment with the occasion, i.e., Happy Holiday, New Years, Spring and Summer. The 5th mailer is for the patient's birthday month. The database campaign runs for 2 to 3 years, each mailer has a different inspiration quote...below are samples to give a perspective of the Viva retention program.
• Happy Holiday • Happy New Year
• Spring Occasion • Summer Occasion

The Dynamics of Database Referrals
According to the United States Census Bureau the average home has 3.2 occupants. This becomes significant for the Hygiene Department as every patient being seen upon return- ing to their home have an average of 2 additional patients that can obtained as a referral.
The average 3.2 occupants per household however expands greatly upon review of additional consumer surveys. Each of the occupants have 2 close friends, called "confidants" (a person with whom one shares a secret or private matter, trusting them not to repeat it to others).
= A patient in Your Practice
= A potential new patient referral
Guaranteed, nearly every patient standing in front of you in your office, has a couple more family members living right under their roof! Simply ask them, please pass along this Viva Pak to someone in your family or a friend! We would love to have more patients like you!
The average family Home has 3 occupants

The market information begins to expose the vital importance of the database for any company. As one sees the below illustrations, every consumer in the practice, upon leaving to go home, enters a household with an average of 3.2 occupants.
More importantly, each person in the household has two close friends, giving a potential of 8 additional consumers that can be referred to the practice. This gives an overview
of the importance of the "REVENUE LAW" covered earlier in this course and why the Inspirational Database Mailers are a key component of retaining and building hygiene department.
Each family member has 2 close friends Each household has 8 potential referrals

Hidden Relations & Loss of Referrals
This illustration depicts a typical interaction between friends and family. Remember the diagram on the prior page where each household member has 2 close friends.
This diagram shows a mother in one neighborhood home (who’s husband is a patient in your office).
She goes to coffee with a close friends, finds out about another dentist for her child and ends up in
“I was thinking about getting my son

No Constant Contact = Lost Referrals
You can prevent referrals being sent to another practice in the area by constantly contacting your database with a warm inspirational message and by providing an introductory offer that your patient can transfer to family or friends.
My daughter just started Invisalign at
ABC Family Dental and she just loves it there!

Lost Loyalty & Retention
Capturing recall patients through repeated database mailings and offering incentives is the single largest business component for revenue growth.
2 New

The loss of 90%+ of all patients is only present due to the lack of application of a retention system and use of the "Business Law" taught in every business school in the countrry.
Business Revenue Law:
The Number of Constant Contacts to the Database determines the revenue growth for any business.
A constant contact to the database is the overiding activity to not only prevent loss of consumers but to improve loyalty with use of communication that can inspire them to do better in life!.
Patients Lost

Action Steps to Reduce the Leakage!
To dramatically reduce the database leakage, the Hygiene Department has to employ or put into place, a series of steps or actions. The following give an overview of the ACTIONS that must be done to reduce the leakage:
1. Patient Education is the key to changing behavior. The behavior being changed is to bring about an increase in awareness of returning for routing hygiene visits. This education step tells the patient about the "Wellness Program" for the patient and their family. Without an education step, or a mission statement for the patient, there is little to no change in behavior.
2. Asking for referrals with a Care To Share program to get family and friends to come to the office under the Wellness Program of the Hygiene Department.
3. Reducing Cancellations with a protocol and cancellation policy and dialogue that reduces the cancellation rate from the industry average of 15% down to 6-8%.
4. Constant quarterly inspirational mailings to the patient database with emphasis on keeping them active on the "Wellness Program" with their next hygiene visit.
These action steps are fully covered in:
The Case Study Implementation Course.
This course takes one through the step by step procedures to stop the leakage and steadily grow the number of hygiene days.

The Residual Based Practice
Statement of Purpose
Align all Staff to 2 Products
Full Responsibility Assigned
Execute Database Mailings

F The retention of patients begins with the "Mission Statement" of the office. The most important factor in achieving the strategy for a residual based practice is to drive home a continuous strong mission statement. Your mission statement is the focal point of all activities in the office... as this is the goal being achieved.
E The Mission Statement is an education step for every patient and is repeated many times. The Mission Statement is posted in reception, every operatory, the hygiene operatories, the hallway and even the bathroom. It is handed to them in printed form on your stationery with the end result of every patient leaving the office with a goal to share with patients family and friends.
Statement of Purpose

Changing Patient Behavior
Patient retention is brought about through an educational system put in place in the office. Cancellations and no shows in both the operative and hygiene department are manifestations of a weak internal office structure.
In other words, there is no structured "system" or "established pattern" that every patient goes through when they enter and exit the practice.
A structured "system" or "pattern of operation" is put in place that every employee follows AND every patient follows. It is a non-optional "pattern," the same routine, day in and day out.
Viva puts this "pattern of operation" in place through training of the Office Manager and Retention Coordinator.
= Mission Statement Hung on the Wall
Operative #1
Operative #2
Hygiene #1
Finance Coordinator Dr. Office
Hygiene #2
Hygiene #3
Staff Lounge
Bath Room
Sterilization, Instrument Preps, Supplies

AF lign all staff to 2 products
Completions Retention
Education to the Level of Never Needing Dentistry in the Future

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