Kevin: Today, we have another guest. We’ve been fortunate enough to get Mr. Jerry Jones for the second time. Mr. Jones is a founder of Jerry Jones Direct, a boutique dental marketing firm focused on patient attraction and retention. All of us in the dental profession know how important patient attraction and retention is and if you don’t, I’m sure Jerry is going to give us some sound information in how we can improve those two areas of our practice. Mr. Jones has been in the dental industry for over 20 years and while not a dentist, he started and owns a practice in Salem, Oregon.

Jerry, thanks so much for taking time out of your busy schedule to be with Ascent Radio today. Our first question and the question that I think all of us as dentists know, we focus in on how many new patients. We should get between 20 and 40 new patients new months. It’s critical, the new patients. But in actuality, the retention of the patients may be more important. Would you agree with that?

Jerry: A hundred percent. By the way, thank you for having me back. It’s an honor to be here. I love speaking to you and I really enjoy your podcast. You’ve had some fantastic guests, you guys bring some great knowledge out here to the dental community and I know it’s appreciated by others listening. So thank you for having me back on. I really, really appreciate it, doctor.

Kevin: You’re quite welcome.

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Jerry: Retention is probably something — you can go to many number of CE courses, obviously not on the clinical side, but any management CE course and I would be absolutely shocked, amazed, dumbfounded if one person spoke more than a minute or two about the importance of retaining existing patients. There is so much focus and so many hundreds of thousands of dollars spent by advertising companies every single month to give the idea that you need new patients in front of you. It’s why you were able to say you need between 20 and 40 new patients a month for a solo GP depending on the type of practice they have and the kinds of insurances they accept and so on and so forth. But nobody talks about retention.

There is no standard statistic that doctors just think about when it comes to retention. In other words, what percentage of your patients should you work at retaining each year, each month, each day and how do you measure it, how do you go about it, what are best practices. Those things are just not discussed in dentistry. And frankly, if you retain the patients you have, you automatically don’t need to put as many more new patients into your practice.

There are some great ways to sort of figure out what your retention rates are like, there is a number of different approaches you can take, but it’s one of those things that if you’re not paying attention to the retention, you’re spending a lot more money, thousands of dollars more a month and you should be or you should have to be just generating new patient phone calls.

Kevin: I could tell you Jerry, as an owner of 14 dental practices here in Massachusetts and still practicing full time, one of the best processes and procedures that we put in place at our company was no patient chart, no patient ever leaves our organization without an owner knowing about it. Because really the retention is more or less a report card in how well our operation is functioning, not only for clinical care, but for patient satisfaction.

I can only share with you our data that we generally average about 948 new patients a month in our 14 organizations. However, we lose between 45 and 55 patients every single month. And then we track those loses and some are by death, some are relocation to new areas and some are dissatisfaction and some are we’re not accepting the patient’s insurance program. That data that we ascertain each month drives our marketing plan. It’s basically tracking where we’re weak and where we’re strong.

Do you have any additional suggestions or recommendations for the group practices, the solo practices or the larger practices such as ours, some processes and procedures that you would recommend?

Jerry: I read about your particular approach in your book. I went through that and I was quite impressed with the thought process that you put into it. The fact that you guys even track it, the fact that there’s accountability not just from a team member standpoint, but also an owner standpoint. In other words, if a patient leaves your practice, that particular owner sits down, they’re communicating with that patient to try and find out can we save them, are they savable. In other words, if it’s a customer service issue or they’re dissatisfied in some way with their service, you make an effort to try and recapture that individual.

You named off the reasons why people leave a dental practice. There is they die or they move or they’re unhappy or there is an insurance issue. Often times, you know as well as I do, those folks who have insurance issues tend to come back. Especially if they’ve had a downgrade on insurance and they’re forced to go to, perhaps, a place that is not nearly as friendly, nearly as nice, nearly as accommodating as the practice they’re coming from so they tend to return. That is a nice feeling, but what we don’t pay attention enough to is you’re addressing very concrete issues that you can really identify and dig into.

But where a lot of doctors don’t address is the idea of a patient who feels that they don’t matter, that they are irrelevant, that they are a number, that they are just another patient you’re seeing and that you don’t share any sort of connection with. I’m going into the relationship side of things as opposed to the statistic or analysis side of things. What I’m specifically talking about is when patients have no feeling of connection to their dentist, to their hygienist, to the staff, to the people that answer the phones that they know better than the doctor, they tend to more easily wander away from the practice. They are enticed by free whitening offers, they are enticed by implant offers from other doctors that they’re seeing advertise.

Every dentist probably listening to this podcast has had a patient that they were seeing as an established patient, they go missing, nobody chases them down, nobody finds out what happens, and then that patient returns and they’ve got three implants. Meanwhile, you do implants, but this patient found someone else that specifically was advertising implants, they were promoting implants, so they were big revenue lost, big opportunity lost because there was no communication, there was no connection, there was no education that was ongoing outside of the regular routine visits.

The retention aspect becomes really important, not just because you want to keep them in your practice for ongoing cleanings, ongoing exams and ongoing opportunities, helping them improve their health, it also goes to referrals and being a practice that is referable. There are so many connection points that make it important that retention is something that’s focused on.

As far as best practices for retention, there are a number of them. The single biggest one is regular ongoing communication that has some bit of entertainment with it, has some bit of education with it and it also has some amount of humility, of the doctor being humble. In other words, the doctor sharing his life, his stories and his team sharing their life, their stories with patients in a format that is not the typical clinically aligned, very sterile format that patient-doctor relationship is typically surrounded by.

I’ve covered a lot of different components there, hopefully that shades a little light on it. It’s far more than just the statistics, it’s the relational aspect and it’s becoming a practice that is referable. In other words, being an office that encourages, that is very clear to patients that hey, we’re a practice that can accept new patients, your referrals are welcome, and actually going so far as to training patients on how to refer. All of these components lead to retention. I don’t know if you have any comments on my thoughts here or what we’ve seen over the last 20 years of doing this, but I’d be interested to hear.

Kevin: What I think you hit on is an extremely important point, it’s sort of the touchy-feely aspect. Deep down, I’m a matter-of-fact sort of guy you don’t mess around, but in the real world, the world that I practice in every day it’s what I call the BLT. That patient wants to feel that people believe in them, they’re liked and they’re trusted. And that relationship, once it’s established, it can be broken, but it’s very, very difficult. I always say that if you are the greatest dentist on the planet and the patient doesn’t like you, it’s going to fail. If you’re the worst dentist on the planet and you’ve built a strong relationship, that patient pretty much will come and go with you through thick and thin.

How you establish those bonds and that relationship you’ve touched on. It starts from the way the patient is greeted to the way the patient is exited from the practice. In our particular conversation today, I cannot tell you how mandatory it is from a process and procedure that if the patient has not been in within 12 months, your computer print-out has to show you that list of patients because those patients there’s been a breakdown in what you’re discussing. There’s been a lack of communication and those people will tend to drift to other practices for a variety of reasons.

Today, with the advent of almost all offices being computerized, that print-out is critical. I’ve been practicing long enough where we had colored charts and if you were in 2002 that you were red and anybody who didn’t have a red sticker showed you that you hadn’t been in in the year 2002. Today, with the computer, you print it out and someone has to be constantly tracking that group of patients.

The next thing is patients typically — today cost-conscious individuals — they don’t want to pay for new radiographs and new records. So many times they’re contacting the office and having the records sent to a new dentist. I personally, when I do my coaching and training, strongly suggest to the front team members that you never send your records to another office. You always send them directly to the patient. The reason I do that is I want to know if Mr. or Mrs. Smith are leaving the practice and why.

Many times with a large group like myself, we’ll find out that Mr. or Mrs. Smith is moving to a different area and I actually have a practice in that area, but Mr. or Mrs. Smith don’t know that. And if that team member at the front desk isn’t coached and trained properly, they just simply say, “Dr. Coughlin, Mrs. Smith is moving.” And I go, “Moving where?” Once I know where, if where I have a location in that area, there’s no reason for that patient to leave our organization. She can stay with our organization.

So the tracking of this information is critical, but I think your point is you’ve got to establish a relationship and a connection. If there’s no relationship and connection, there’s no bond and the patient is much more likely to move on to different marketing approaches, as you mentioned, a free cleaning, a free tooth whitening, et cetera. I believe for our listeners here it is critical that you’re tracking the retention of your patients and any loss patient, in my opinion, is too many. And whatever steps you can take in your organization to reduce or minimize that loss and increase your retention is not only a tremendous attribute to your team and to yourself, but it also affects your bottom line. Most people in business realize it’s much, much less expensive to retain patients than to solicit new patients.

Jerry: Yeah, 100 percent. I’ll give our listeners a couple of really great tips. Rather than wait till month 12 or month 13 to learn that a patient hasn’t been in, most patients these days are on six-month recalls. Some are on three or four months, depending obviously on their health conditions, but most patients are on a six-month recall. For those who have a six-month recall model, why would you want to wait till month 12? You should actually be doing everything you can to find out at month seven, month eight, who missed their six-month appointments. Because the longer the time elapses between your last interaction and you reaching out and contacting that individual, the less likely you are to get them back in the office. So every day time marches on, situations change, you’re less likely to get that person back.

Where that relationship is really important with your front office team with those patients is being on the telephone with them at month seven and saying, “Mary, my goodness, Dr. Smith just told me that he just noticed that you hadn’t been in for your six-month re-care appointment. We had you scheduled and we noticed you’d called and you needed to change that appointment. I’m just calling because we noticed and we know you don’t want to wait till month 12. We want to capture any issues that maybe you’re having now,” or perhaps there’s some treatment that was prescribed that can be discussed with that opportunity. But the longer you wait, the less likely you’re going to get that patient back.

I’ll mention two other things really quick; the two easiest ways to keep that relationship strong and keep that bond strong with patients is regular monthly communication through the U.S. Mail using a regular old newsletter that shares information about what’s going on in the practice and with the people in the practice doing a little cross-selling and education at the same time and even an electronic newsletter. I’m not a huge fan of email, but they do get opened and some do get read and some do acted on. Because it’s free to send, it’s not something that you should ignore. You should actually do it because it can have a marginal impact. But the most important one is a regular monthly communication by newsletter to your existing patients every single month. That keeps that relationship fresh, it keeps you in front of them and it keeps you more referable and top of mind with your patients.

Kevin: Jerry, I know with your 20 years plus experience in your company, Jerry Jones Direct, the boutique practice, with your vast years of experience, is there some general guidelines for a solo practice that you would say you’d like to see that you never lose more than let’s say 5, 10, 15 or 20 percent of your patient base over the course of a year? I know it’s difficult due to demographics, people moving in and out of the city much more frequently than in suburbia land, but is there some rules of thumb that our listeners could take home and as they run their reports and they look at the data they can say to themselves, “Geez, we’re not retaining as many patients as we should.”

Jerry: You bet. I’m going to go middle of the road. This is not a practice that’s located in a city where there is an abnormally high number of transitory traffic, people moving in, moving out like say a military base. This is going to be for your average community in America, 50 to 100 thousand people. If you’re losing more than five, at most, eight percent of your patients on an annual basis, you’re doing something majorly wrong. Something is majorly wrong. If you have 1,000 patients and you’re losing more than 50 to 80 patients a year, there’s something wrong. You should not be losing that number of patients beyond death, moving to a new state, those items that you can’t help. But if you’re just losing them, they’re not showing back up or re-cares and so on and so forth, you’ve got some problems. That’s when you do a look in the mirror. You probably know what the problems are, maybe you just don’t want to face them yet, but I would say between five and eight percent.

The national average is ten percent. If you do no marketing of any kind to your existing patients, if you just add new patients, you’re going to lose ten percent a year doing nothing. You should be able to drive that down and cut it in half. Your statistics are fantastic, which would indicate that every new patient you add your practices should be growing by 30 percent a year, based on — I haven’t run the math but I’m just going to shoot and guess — your practices should be growing wildly if someone is only losing 50 a month and they’re adding 900 a month to an organization your size. Those are tremendous numbers.

Kevin: As I like to say, Jerry, dental domination. As a general rule of thumb I look for between 2,000 and 2,500 active patients. I describe active as they’ve been in the office within the last 18 months. I look for revenue of greater than $2 million and then I say to myself it’s time to look for a different area and open up another practice, either a de novo practice or I look for an individual who’s looking to sell their practice. And I start the process all over again and that’s what I’ve been doing for 35 years. It’s simple, it’s reproducible. It’s certainly not for everyone and I don’t recommend it for everyone, but for our listeners, I try to share a little bit of my personal story each time I do a podcast.

I can’t thank you enough for your expertise. For our listeners, Jerry, if they want to pick your brain, they want your expertise and knowledge, they want to learn how to retain patients and grow their practices so they have a fantastic boutique practice, one that they’re proud of and one that provides the level of care and service that they’re proud of, how can they reach out and get in touch with you?

Jerry: The easiest way is by email. It’s very simple, If they’re old school and they want to pick up a telephone, 503-339-6000. I’m happy to give anyone a 30-minute no cost, no hustle consultation where we could speak about your practice and where your goals are and see if we might be able to be of some service to you.

Kevin: For our listeners, I want to thank you for listening to Ascent Radio. This is Dr. Kevin Coughlin. You’ve been listening to Ascent-Dental-Solutions. I want to give special thanks again to Mr. Jerry Jones. Reach out. His expertise is invaluable and I can’t tell you enough that the key isn’t new patients. The key is retaining the patients that we have and providing the highest level of care and service that you’re capable of.

You’ve been listening to Dr. Kevin Coughlin and before I sign out, special thanks to Mr. Doug Foresta and his company, Stand Out and Be Heard. Again, without his expertise in podcasting, I wouldn’t be able to bring you these weekly podcast. Jerry, thanks again. I look forward to speaking to you in the future. Keep up the great work. We really appreciate your expertise and how you’re helping our profession.

Jerry: Thanks doc.

Kevin: You’re welcome.