“We will be restoring the lower right side on the next visit. Your old restorations have outlived their usefulness.
"I know we’ve been preparing you for this for a while now, and it’s time. Nothing lasts forever, but you did get a very long life out of your old dentistry. With the proper care, you should get the same life expectancy from your new dentistry.
"Now, if we could have a moment of your time, we’d like to help you with the fee for your treatment and the payment options we have available. Let’s see what’s most convenient for you.” Then you escort the patient into the private consultation room where the financial coordinator is waiting to complete the process.
"Something else of great importance is the daily retention rate for both the doctor and hygienist. Did the patient schedule his or her next visit? I consider any patient not scheduled for an appointment inactive, so tracking these numbers is critical to the health of the business.
"Your goal should be to have all patients walk out with at least their two next appointments scheduled, either doctor and hygiene or two hygiene visits."
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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.
New Patients into the Practice
Patients in the Practice
Patients leaking out the backdoor
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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?
30
=
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.
160/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.
=
160/mo.
320/mo.
480/mo.
640/mo.
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Database Dynamics
Definition of Dynamics:
We are referring to the dynamics of the database, which are defined as the activities occurring with these people when they go home and interface with family and friends.
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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 Unopened
Vivapak Opened
The Viva "Care to Share" Gift Pak
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
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The Secret to Increasing Case Acceptance Growing the Active Patient Count in the Database
The most important aspect to improve case acceptance in any practice is through an understanding of the four business laws and how they relate to consumer retention. 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: incomplete treatment in dental offices across the country averages 60-65%. This equates to 6 out of 10 charts having unfinished treatment.
All of a sudden the importance of Consumer Retention becomes extremely important. There are several reasons for this:
1) Consumer retention: always increases CASE ACCEPTANCE. A patient is much more likely to accept his recommended treatment on the second and thrid visit.
2) Education increases the patient's understanding of why he needs treatment and thus increases case acceptance.
3) Trust: a patient is always more likely to accept treatment due to improved trust with the doctor and staff.
4) Referrals: returning patients improve consumer acquisition (lower case) as they are more likely to
refer their family and friends.
CONSUMER RETENTION ALWAYS INCREASES CASE ACCEPTANCE
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Growing the Active Patient Count
Active Patient Count: is simply defined as the total number of hygiene recall visits for the year, divided by 2.
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 FOUR BUSINESS LAWS WORK TOGETHER TO INCREASE THE SIZE OF THE ACTIVE PATIENT COUNT
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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.
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.
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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.
Residual Income Continues
Dr. Stops Working
Income drops to zero
Time
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Total 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 recare.
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.
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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.
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Total Production $
Residual Income Linear Income
Residual Income Linear Income
Residual Income Linear Income
Residual Income Linear Income
Linear Income
Residual Income
• • •
•
e dynamics and growth has to understand the
come.”
Increased loyalty from patients
Increased income from the hygiene revenue center
Increase in word-of-mouth referrals is generated due to the increase in people coming in and out of the office.
Less dependancy on the owner/doctor being the primary provider for the office and working toward removing the hand cuffs from owner/doctor.
Retention
me
Five 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
Loyalty
Increase Referrals
Hygiene Revenue
Transition
Higher Acceptance
Residual Case
Income
More Free Time
Income Security
n:
ome is income that continues to be generated
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o
e n
o
tial effort has been expended. Also called