Practice Marketing
By Dr. Dean
C. Bellavia
Lets face it!
There is no magic pill we can swallow to market our practice just our
pride. The world doesn't owe us
patients just because we have spent 22 years and $220,000 on our education and
untold amounts to physically establish a practice we have to earn our
patients! There are also no simple
marketing gimmicks, for example, sending a rose to referring mothers that will
assure us a sound position in the orthodontic marketplace—marketing is hard
work!
There are two types of marketing: internal and
external. Internal marketing is based
on having the best staff, systems and attitude to make our patients feel that
they are receiving more than what they are paying for. Internal marketing relies on the well-served
patients referring their friends and acquaintances to share in these wonderful
services. External marketing is a
matter of awareness, based on creating interest in our services from without,
by letting them know that we exist.
Every practice needs both external and external marketing.
Much of the external marketing today is attained
through dental professionals and other individuals who know about the practice,
believe in it, and want others to receive its services. This external marketing technique is based
on the practice's image in the community.
It takes constant effort to keep this image positive and to keep others
referring. It is also a hit-and-miss
proposition since the referrers are NOT under our direct control and we have
little say over what they do. External
marketing of referrers is more
work-intensive and less cost intensive than external marketing through advertising. Advertising is an external marketing technique that is used by
few orthodontists today. The purpose of
advertising is to spark an interest in orthodontic treatment in people who
don't know that our practice exists, which is accomplished through
repetition—advertising only works when it is repeated for a long period. Every potential patient/family needs a
specific amount of time, sometimes days and sometimes years, to be convinced
that they may need the advertised service.
And once convinced they will seek out that service and either accept it
or not, depending on how they are treated.
External marketing through
advertising is very cost-intensive, for example, a well-known orthodontic
management group spends about $50,000 to $70,000 a year per practice on
advertising. To set up an external
marketing plan for your practice you need to decide on whether you want to
spend much time and minimal expense to interest possible referrers, or whether
you want to spend minimal time and much expense on advertising.
If REFERRAL is the route you prefer you
must build your relationships with referring dentists—there are other referral
sources, but dentists are by far the best referrers. Each relationship must be built on what you can do for the
dentist's practice and NOT on what the dentist can do for your practice. And no matter what you do, it must all be for
the patient's welfare in the long run, if it isn't good for the patient, it
isn't good for anyone. The referring
dentist is ultimately responsible for the dental welfare of the patient. Thus, as part of your referral, marketing
you must place special emphasis on getting patients back to their dentist
regularly for their cleaning and exam visits.
You must also support the dentist's endodontic, periodontic, oral
surgery, prosthodontic and restorative services as well as their cosmetic
dentistry services. To do this you must
have meetings with the dentists to determine the specific services that he or
she provides. You must also determine
who they support and want you to send their patients to for service he or she
does not provide.
Dental referrals are not just stimulated between
dentist and orthodontist, but between the dentist's staff and orthodontic
staff. To get this type of referral
started, invite the entire dentist's staff for a get acquainted lunch with your
staff at a local "fun" restaurant.
Once acquainted, have them visit your orthodontic practice for another
luncheon to see how you deliver your service and the special ways that you
support their practice through referral back to them and through working with
the patient to become a better dental patient.
Show them the communications that you send to keep them informed on the
patient's treatment progress. Have a
dentist data record on each dentist's practice so that when they call you, or
you call them, you know all about their practice and can speak more as a friend
than as just another office. Having
this data computerized for quick access is very helpful! The dentist data file can show staffing data
such as who is the receptionist, hygienist and office manager. It can also indicate how the dentist would
like his or her patients referred for other specialist treatment. The data can also contain personal
information such as staff birth dates, anniversary dates, their interests, etc. If computerized, you can also automatically
access data on the number of referrals made to your practice and the number of
new patients that you referred to the dentist.
You can also list the number of times your practice has been able to
make a hygiene appointment for a parent directly over the phone if you want to,
there is no limit on what you can know that will benefit your effective
interaction with referring dentists it is only limited by your
imagination! But don't forget, the
computer is only a technical aid for you and your staff; it is people that
create referrals, not machines!
If ADVERTISING is the route, you prefer
you must create credibility with the "ad-patients" through your
advertising since they probably don't know anything about your practice. Also, a significant percentage of ad-patients
have not had a professional suggest that they need orthodontic treatment; they
are just there to find out. In general,
the starts to exams ratio (conversion ratio) for
ad-patients is about one-half of what it is for your normal referred patients,
meaning that you need twice as many exams for the same number of starts and it
seems that only about half of the ad patients actually show up for the exam
anyway. Thus, you have to schedule three-to-four times the number
of exams to get an ad-patient started as you do to get a referred patient
started. But advertising is a proven
method of getting patients, and if you are willing to have more patient exams
at a lower conversion rate ending up in more starts, then go for it. Just make sure that the increase in your
gross is worth the expense of advertising and the increase in your days worked.
Few practices rely totally on ad-patients, so if you
want to advertise you must think of that advertising as an investment of your present net income to have a higher future net income and increased
workload. In general, for every $1,000
you spend in advertising you should get $10,000, and never less than $5,000,
worth of gross income on ad-patients started. Another aspect of adding advertising to your
marketing is that you must keep track of every ad-patient that calls, has an
exam, and starts. If you do, you will
know how much gross income is generated per $1,000 spent on advertising and if
you aren't willing to spend at least $30,000 or $50,000, don't bother advertising! So much for the up side of advertising, now
let’s look at the downside. Most
advertising works because a lower fee, for example, 20 percent lower, or low
financial arrangements, for example, no initial payment and a low monthly
payment, is advertised. Thus, if you
are not willing to do this your ads will probably be ineffective and your
ad-money wasted. Also, most referring
dentists don't advertise nor do they like specialists who do. And unless you are willing to gamble on
losing some of your referring dentists, don't advertise, you may lose more in
new patient referrals than you gain by advertising, thus wasting your
advertising investment. Also, patients
in this day and age tend to look at advertising practices as less professional
than non-advertising practices and may avoid them for that reason. In general, it is better to improve your
services, which is controllable, than to advertise, which is a crap shoot if
not done to the limit.
Internal marketing is a matter of internal organization; organizing the right
people, under the right circumstances, to provide the treatment the patients
need and want. This takes time and
effort, but it is under our direct control since we can hire and organize the kinds
of people we want in our practice and establish systems that promote our
practice internally. Once organized and
maintained, internal marketing perpetuates itself at no extra cost to the
practice. Internal marketing takes on
two forms, interest and service.
INTEREST is generated in the practice through contests,
gimmicks, and in general, fun things
that makes the patient/family happy and excited enough to talk about your
practice between appointments. For
example, having seasonal (holiday, sports, etc.) contests where the patient can
win prizes is always fun, especially when the doctor and staff are enthusiastic
about it. Refer to The Book ... on
orthodontics for scores of examples of fun ways of marketing your practice
through interest. But be aware, no matter what fun things you
do in your practice, if your service
is not adequate you will lose most of your internal marketing advantage.
SERVICE is provided by staff who are knowledgeable,
experienced, and have a personality that is suited to their work position, using
proven management systems. To
appreciate what it takes to effectively internally market your practice, let's
take a chronological tour through an exceptional practice from the new patient
phone call to the end of retention.
Throughout the tour we will refer to information about staff,
personality that was covered in Part II of this series.
Your tour as
the patient through our exceptional
orthodontic practice! (The “E” comments help to clarify
why we are an exceptional practice.)
·
Your
marketing tour begins with your initial phone call for a new patient
examination appointment. A friendly,
comforting voice answers, "Good morning, Dr. Toothman's office, this is
Alice, how may I help you." Alice
has time for you and is not rushed because you are important! But if Alice is very busy at that moment,
she transfers you over to an equally comforting and competent staff member who
can obtain the necessary data and give you the best appointment available.
·
Before
your exam appointment, you receive in the mail a brochure and a welcome
letter/photo introducing our treatment coordinator; you also receive a Health
History Questionnaire to fill out at your leisure. A day or two before your appointment date our personable
treatment coordinator calls you to give you instructions on how to get to our
office and also answers any pre-appointment questions you may have.
·
When
you arrive for your appointment where you are greeted by our receptionist in a
friendly atmosphere where it is obvious that our staff enjoys working together
to serve you. Our receptionist asks you
if you would like refreshment and gets it for you before she notifies the
treatment coordinator of your arrival.
·
Soon
after your arrival, the treatment coordinator (TC) greets you and begins a warm
and personal relationship that continues throughout treatment. The TC's helps you to get started with your
orthodontic treatment and keeps you informed of your progress throughout your
treatment. As you enter our well
designed, bright and comfortable exam room our TC then obtains pertinent data
from the patient including a "New Patient Welcome Questionnaire"
which tells us what makes that child happy.
Every child patient's opinions and facts are important to us and thus,
the TC asks the child patient all the pertinent questions and reserves the rest
for the parent all our patients are treated as if they are very important
people, for they are!
·
When
the TC has completed your initial interview, she may use a camera and computer
to take non-radiographic Video Imaged Photos of your teeth and face. The TC may also show you an eight-minute
interactive CD-ROM presentation of the various types of malocclusions, while
she obtains the doctor for your clinical orthodontic evaluation.
·
The
TC promptly returns and introduces you to the doctor using your nickname or
preferred name. The doctor focuses on
you to get to know you personally and to understand your orthodontic concerns. After that, you are seated in the exam chair
the doctor does a comprehensive exam and dictates his findings to the TC who
records them. The doctor then briefly
discusses your orthodontic problems and the treatment required to resolve those
problems using visual aids, computerized if available. The doctor thanks you for selecting our
practice for your orthodontic treatment and you feel well served because you
can see your problems and solutions clearly portrayed and understood.
E The doctor is available to
spend the time required to do a comprehensive, people-oriented exam because the
schedule has set aside the necessary time without holding up the clinical staff
and the other scheduled patients.
·
After
the doctor leaves the TC completes an Exam
Summary Card, which clearly summarizes your problems, treatment, fees and
possible financial arrangements that fit your budget. The next step is for you to take your initial records that have
been automatically scheduled to save you an extra trip and to keep from
delaying your treatment any longer.
E Patients go ahead with
treatment when they are served well and their financial arrangements are
realistic. When a practice gives
exceptional service through its exceptional people and has flexible payment
plans, it will have a 75 to 85 percent conversion of exams to starts instead of
the national average of 50 to 60 percent.
·
After
your records are taken and the doctor does your personalized diagnosis and
treatment plan. You then have your case
presentation visit that the TC has thoroughly prepared for. At this visit you are educated as to exactly
what your treatment entails, what the practice is responsible for in providing
your treatment, and what your are responsible for, for making your planned
treatment a success. You are given a complete
analysis of your problems and the types of braces required to resolve those
problems along with the risks and limitations of your particular orthodontic
treatment. Your credit has been checked
electronically, you are credit worthy, and you can start treatment as soon as
possible. You sign a financial
arrangement that works best for you: you can pay for your treatment in full,
you can pay the usual 25-35% initial payment and the balance over your
treatment, you can pay NO initial payment and extend your payments even longer
than your treatment time, or do whatever fits your budget we are here to serve
you and to make it as easy as possible for you to receive the best treatment
with reasonable financing. You can even
choose the time of the month that is easiest for you to pay by; and should you
ever have a period of financial difficulty we can have a friendly discussion
about how to handle your finances to help you get through that period. At the end of the case presentation, you
receive your separators and/or impressions and get your braces in a week or so.
·
You
arrive for your braces and are greeted by all the staff that is happy to
welcome you as a new orthodontic patient and a friend. Your braces are placed efficiently and you
are effectively trained in their care and cleaning. The day or so after your braces are placed you receive a call
from the doctor, TC or other staff member to make sure that all is going well
with your braces, and if not, you are brought in to adjust your braces to make
them more comfortable.
·
Throughout
treatment, you are served by competent, personable staff that enjoys working
with you as a team in providing your treatment. You know that we can't do it all and that you need to take care
of your braces and wear them as directed by the doctor. When you arrive at each visit you sign in,
or if computerized, you select your name from the screen when see your photo;
this notifies the doctor that you are there.
You are seen promptly, on schedule, as 85 percent of all patients are
seen on time.
·
At
each appointment, you receive your scheduled treatment, which the doctor had
specified at the last appointment. By
knowing what you will require beforehand the receptionist has reserved this
specific appointment for you, which gives the doctor and staff enough time to
provide you with the best possible service.
Your treatment is charted to assure maximum control, and if computerized
your chart is electronically available at the treatment chair along with all of
your computerized diagnostic records.
If so, the doctor or assistant enters into the computer the treatment
provided, along with the treatment required at for next appointment. Also, any follow-up required regarding this
visit is entered into the computer for the staff member who will do the
follow-up; that follow-up request is added to that staff member's daily
"To Do" list and is completed as scheduled.
·
When
your treatment appointment is over you get to visit with our wonderful
receptionist for your next appointment.
If your chart is computerized at the treatment chair, your appointment
has already been noted and the receptionist automatically gets a selection of
the available appointments when she enters your name into the computer. Your next appointment is scheduled at the
most advantageous time that the receptionist has available and you receive a
printed appointment slip as a reminder.
If any letters are required, they are requested automatically; for
example, after your exam appointment the Post-Exam Welcome Letter was
automatically sent to you introducing all of our staff.
·
At
every appointment you are informed of the treatment, you are receiving and how
it will help your overall treatment; if a child patient, it is also explained
to your parents. When you receive a new
appliance that requires special care and use, for example a headgear or other
removable appliance, you are thoroughly trained in its care and use. The doctor or the dental assistant who
helped the doctor place your appliance will call you the next day to see how
you are doing with it.
·
Your
treatment progresses as scheduled since 95 percent of all treatment is
completed on time. This is controlled
through our accurate diagnosis and treatment planning, your cooperation, and
our enlightening six-month reviews.
Every six months the doctor is reminded that a progress review is
due. At the progress review visit, your
planned treatment is reviewed and you are progressing as scheduled. You are given a Progress Review Report
indicating that your treatment is on time and that you have done very well at
maintaining your braces, wearing your removable appliances, and keeping your
appointments on time. If computerized,
this information is automatically deciphered, analyzed and printed out from data
entered at each of your previous appointments.
If a child, your parents are happy to see your progress and how well you
are assisting us in providing your orthodontic treatment; and your dentist will
be happy to see how well you are doing when he or she gets a copy of your
progress report, which is also a treatment request for a periodic cleaning and
dental exam. When you check out from
your six-month review appointment the receptionist is automatically notified to
call your dentist so that you can make an appointment as soon as possible to
get your necessary periodic cleaning and dental exam.
·
When
the joyful day arrives and your braces are removed, you have your final
evaluation of your treatment result, which indicates that all that was planned
for you was accomplished. You are also
referred to your dentist for a thorough cleaning of your teeth, and any
cosmetic, etc., dentistry that may be recommended to enhance your excellent
treatment result. We share in your joy
by giving you an appropriate gift and we all take a picture of the event. After your final records are taken we send a
"before and after album" to your family dentist to give to you at
your next appointment with him or her so that he or she can also share in the
joy of you beautiful new smile.
·
You
receive your retention appliances a few days later and are placed on a series
of "recall" appointments that are concluded when your teeth have had
time to permanently adjust to their new, ideal positions. Your retention treatment is a success because
you have worn your retainers the required amount of time each day during
retention.
·
The
bittersweet day arrives when you are done with retention and thus all of your
treatment in our office. You are happy
to have completed your treatment, but you are sad because you will no longer
enjoy an exceptional service that went way beyond just excellent treatment, and
this experience will always remain in your mind as one of the more positive
aspects of your life. But we are always
here to say hello and find out how well the rest of your life is progressing
when you visit us from time to time in the future.
This people-oriented, effectively planned,
excellently scheduled approach to treatment management usually reduces treatment time by up to six
months and makes the doctor and staff more effective and productive each
treatment day. The more efficient use
of the staff in the scheduling of appointments, the lower the total chair-time
for the total treatment. Thus, this
total management approach usually increases the number of patient starts by 30
to 50 percent without any increase in staff or treatment days, and it usually
does it without any increase in new patients if the practice has the average 55
percent exams-to-starts conversion rate.
But if more new patients are required, a successful marketing program is
necessary and the program must be properly managed by determining what has to
be done, when, by whom, at what cost, and where the money will come from. This means that specific goals must set for
all internal and external marketing, for example, that an additional $50,000 in
charges will be generated form ad-patients or new dentist referrals this year.
This also means that data must be collected and analyzed to determine
whether these goals have actually been met.
You must keep accurate statistics about the sources of your new
patients. Thus, the TC must take extra
care when determining what made the patient finally decide to contact your
practice. A simple statement such as
"Who can we thank for telling you about our practice?" will get
accurate results about 95 percent of the time with the other 5 percent
requiring a follow-up question or two to determine the source. Once you have accurate data you can
determine exactly how many of your new patient exams and starts came from each
marketing source, that is: patient referred, dentist referred, others-referred,
or advertisement-referred.
Internal marketing by definition is properly managing your exceptional
patient services as your tour through an exceptional practice infers. Exceptional practice management must
include: hiring, training, and monitoring exceptional staff to work in
positions that they are naturally suited to; effectively and productively
scheduling that staff and doctor; and, using all of your staff to provide
effective people-oriented communications with the patient and family. All this must be accomplished manually
working with people. It cannot be
established by just buying a computer with management programs. But, once the exceptional management is
established manually, there is no better tool for helping to effect that
management than a well-designed computerized management system with at least
the attributes mentioned above. Just be
careful not to fall prey to the claims that a computer system will manage your
practice for you—there ain't no such animal!
When giving service to patients the more you manage with humans and the
less you manage with machines, the better.
But the more your computer system supports
your human effort the better. For
example, the TC can display a list of will-call-back patients on the screen,
pick one, call and schedule them to start, and enter the results of the call
without leaving the keyboard. This
brings up the important point! Even
though you market your practice well and get the patients into the practice, it
doesn't mean anything unless they start.
And since about 15 to 30 percent of all new patients become
will-call-back patients, they must be followed up upon. Having a sophisticated reporting/control
system that gives you accurate insightful monthly reports can help you do
this. For an example of such a system,
refer to the article “Goal Oriented Management”, which describes a reporting
system that allows you to control your well-managed marketing systems and your
practice in general.
There are many ways to market your practice, both
internally and externally. If you
prefer to do it mainly externally, either totally go the referral route or
totally go the advertising route going halfway with either costs much and gives
little in return. If you prefer to do
it mostly internally, organize your practice to be a fun place to give and
receive exceptional service. Give
exceptional service through every staff member, based on their personality,
abilities, and belief systems using effective management systems. Install these systems manually, although
once installed, computerization helps to keep you on your toes and to continue
providing your exceptional service.