Webinar: Strategies to Actually KEEP Patients

Alec Goldman: My name is Alec Goldman, I lead branding content here at NexHealth and I'm hosting today's webinar on strategies to actually keep patients. My friend, Laura Nadler, she's the founder of Working Cat Marketing, will be leading today's conversation. If you do not know Laura, she can be found speaking internationally, including at the ADA, ACP, Tufts, BU, covering all things like branding, marketing, and using video as our marketing strategy.

We're very fortunate to have her here today covering strategies to actually keep patients at your practice. Laura, welcome, and thank you again for joining us. I'd love to pass the baton to you and dive right in. 

Laura Nadler: Awesome Alec, thanks so much for having me. I always appreciate being on here with the folks from Next Health. You guys are doing great stuff in the dental space. I know that we'll share a lot of what you do today because so much of it is about keeping patients. The first thing I wanna start with is, particularly for folks who did join us last time, you may recall that I talked about how we count new patients. And that's why my title today is, Was it a Blind Date? Because very often we're taught when we take practice management courses that as soon as a new patient comes in, we sort of tick that off. It's, okay, I acquired a new patient, and we set our monthly goals based on that. Maybe you want five new patients a month, or maybe you want 20, everyone's goal is different, but when do we actually count them? And we do have a tendency to say, okay, they walked in, they had a pulse, they showed up for that first appointment, they're a patient. But if you're on here today, you wanted to know how to keep them because you've determined that that's not really true. They may have come that first time, but then they didn't come back.

They're deciding, do I like you? Do I like what your practice has to offer? Did I get a good vibe here? Did you have brown shag carpeting and I ran for the hills? Whatever their reasons are, they didn't necessarily become a patient. So today we really wanna talk about those things that get folks to stay. And we're gonna divide that into three chunks. 

And the first is that first impression. We experienced this everywhere in our lives. It's not just your dental practice. Every person you've ever met, every person who's met you, we form opinions based on that initial impression. And we can debate whether that's fair or not in this life, but we know it's human nature. We do size people up sometimes, simply based on the way they looked or where we met them, and the environment they were in.

And folks are doing that in your practice every day when they first show up. We're also going to talk about meeting the need, meeting needs that your patients have, meeting their expectations, and even more importantly, exceeding those expectations. Because I think we all know if we've ever been to any sort of business and they met our expectations, you know, I went to a restaurant, they served me a meal, I survived the meal, and I paid an adequate price for it, I'm probably not giving that restaurant a five-star review.
But if they exceeded my expectations, if the food was better than I expected, if the service was incredible and I paid my bill, then I'm probably thinking, okay, that's a four or five-star review because they exceeded my expectations. And patients who stay with our practice, patients who go from new patients to raving fans are the ones for whom we've exceeded those expectations. So let's talk a bit about those first patients coming in. And this statistic makes me insane because on average, 40% of new patients don't reappoint. Now I know one of the folks in our chat asked a question or mentioned that one of their biggest pain points was cost and thank you for saying that because here we are talking about it right up front. Patient acquisition is expensive. And if we're getting folks to show up but not stay, we're literally just throwing that money away.

And I don't think any of you would take $300 bills, crumple them up in your hand and toss them out the window. But that's what's happening if we don't keep those patients. The folks at 1-800 Dentist did a survey sort of kind of asking folks why you stay with a practice, why you don't stay with a practice. And I think this is incredibly telling. The single most cited reason that they didn't stay with a practice was a sense of indifference. That I came to a practice and I just felt like they didn't care. I was another patient, another number, but they didn't make me feel special. They didn't make me feel like an important part of the practice and I walked away. 70% of people said that was the biggest reason. So that's really what we need to focus on. 

Focus on understanding who they are as people and doing the things that they as people want. And we're gonna talk about a number of different ways where we can meet and exceed those expectations so that a sense of indifference is never a reason that a patient walks out of our practice. So a couple of things I wanna bring up, even before the patient comes in, and these are the things you wanna make sure you're doing before they walk into the door. It's almost 2023, folks. It's less than a month away, so no more paper. So I know we all used to do that thing of, oh, can you come in 15 minutes earlier? We're gonna have you fill out your health history and your paperwork and your blood type and how many dogs you have and all this history we want about a patient. I hope that right now you're offering a way for patients to do that before they walk in the door, because this makes a tremendous impression. I will tell you, even in the past year, here it is, 2022, this technology is very much available, and I have had both sorts of appointments myself personally. I've had ones where I was directed to a patient portal and I was able to do everything there, upload my insurance card, tell them my whole life story. But I actually did have an appointment that gave me the come in early to fill out paperwork. Now, ironically, that was a chiropractor who I had seen in the past and they wanted me to update my health history. And I thought, gosh, really? In this day and age, that should be something I should be able to click on right there on my phone and be able to say to them, OK, this is what's changed. This is what hasn't changed.

So our very first impression happens before the patient even shows up. Hopefully they've had a phenomenal first phone call with your patient coordinator and that person has sent them a link so that they can come in and they can, before they come in, fill out all of the information that you need, insurance, health history, whatever it is. That's already saying to a patient, okay, this is a high-end practice. This is a practice that gets the century we live in.

Understands that my time is valuable too as a patient, and I don't wanna spend it sitting in your office for an extra 15 minutes filling out paperwork. I wanna do that when it's good for me when my time is most useful to take care of this. So please make sure that's something that we're doing. Now they're actually gonna walk in the door, and this is where we get to make our first impression. And I'm gonna suggest that you do the same thing that they did to you before they chose you as a practice.

In this day and age, virtually everyone has some sort of online presence, whether it's a Facebook page, or a LinkedIn page, there's some opportunity for you to be able to see what a patient looks like before they come in the door, for you to be able to call them by name the minute you see them. And that may seem like an inconsequential thing, but I will tell you a story of an appointment I had.

Just about two years ago, I thought, my goodness, I have such a big online presence, there's no reason this should have happened. And it gets even more telling when you see who was in the office. I walk in, there are two other patients sitting in the reception area. They are both male. I am on time for my appointment. I walk up to the front desk, and the woman looks at me and says name? And I thought to myself, I'm pretty sure neither one of these men is named Laura.

So what a strange question to ask me. Wouldn't you have assumed that the only female walking in at this time of disappointment was someone named Laura. So having the ability to say to me when I walked in, hey Laura, welcome to the practice, would have meant the world to me because it would have meant they had taken that extra step. We've all seen these sort of welcome boards. I think one of the places this really got started was in the veterinary industry.

But it is becoming more and more prevalent in ours. And I love it. I love the idea of welcome to our new patients today and seeing my name there. Now, obviously for HIPAA reasons, let's stick with first names only, but it's just another way to say, we were waiting for you. We're welcoming you to the practice. These are all those first impressions that change how people see us. And the next one is your practice itself. Now, you heard me joke earlier about if it's a brown shag carpet, and maybe that's gonna turn off a patient. Who knows, maybe that's their style. But most importantly, I want you to make sure that your practice, especially that reception area where they first walked in, looks like the brand that you promised them through all of your marketing. And the big thing about that is what I like to call the stuff of dentistry. There's a lot of stuff we need to run our business.

We've got pamphlets and brochures everywhere. And once we get back to the operatories, we've got all the tools and all the little jars of Carpewools and two-by-twos. These are the things that typically keep patients from wanting to come to a practice. So be aware that our stuff, the stuff we stop seeing every day because it's there in front of us, are the things that are gonna catch a patient's eye. The neatest possible reception area you can have, the one that looks like your brand.
So if your brand is warm and homey and cozy, that's what your reception area should look like. If your brand like this image is sort of a high-end chic spa experience, and this happens to be a place, Prosperity Park Center for Dentistry, this is their beautiful spa-like front area, that's what you want a patient to see when they walk in, because we want them to believe in the brand that made them first show up at your practice. And let's talk about how your team does it.

Every time you talk to that patient, especially when we first meet them, call them by name. It helps as we introduce them to folks in our practice from the reception area back to hygiene or to the dental assistant, that we practice a warm handoff, that we say, Suzy, I'd like you to meet Alec. His first appointment with us was today. He just finished taking care of all of his information. It's all in the system. And then we hand them off.

And then as they move to the next place, maybe they come back up to the front to take care of billing or their next appointment, hand them off with the name, mention that they were a new patient, make them feel welcome and special every time you talk to them, but also when you refer them or hand them off to other folks in the practice. Again, it's just a way to make them feel that it's not a sense of indifference, it's a sense of caring.

And I want you to also remember it's all about that. So I know that when we're presenting treatment plans and this gets into our meeting expectation, we like to diagnose. What I want us to focus on are what they wanted, what they needed, and what they might've been afraid of. So let's make sure that when we present our treatment plans, we're doing this in patient-friendly terms. 

All of us on here right now, know what a number 30 MOD is. And all of the patients look at that and say, I have no idea what number 30 MOD means, even if we put the word composite in there. Because a composite means something very different to folks outside of the dental industry. So let's make sure we're careful about not using a lot of our jargon when we treat and plan for patients. Now I know your system, whatever it is you're using in your practice, Dentrix, whatever it is, is going to give you a nice printed-out color-coded treatment plan. And it's lovely and it's helpful, but it's not in human terms. So let's make sure we also give them a version that's in what I like to call plain English. Whatever the language of your practice is, use the terms that our patients are going to understand. And make sure you give them one to take home. Because although you may have a patient who can say at that appointment, yes, I'm ready to move forward with this, let's schedule an appointment.

We understand that in the real world, a lot of us have partners, spouses, family members who are gonna need to say, hey, this is a treatment I need to do, it's gonna cost X, and we want them to be able to confer with that family member so that they can confidently move forward with the treatment. And again, make sure that goes home in human non-jargony terms. And let's remove those barriers to getting them to yes. So I know that any practice in the world out there. We'll happily take cash, check or credit cards. I also hope though, that we're offering alternate ways for our patients to pay for treatment because money is the single biggest barrier to getting a treatment done. So let's offer them different options. 

Now, maybe your office practices in insurance plan, maybe they participate in some, maybe they'll participate in any, there's all different ways that we might do that. But whether there's insurance involved or not, there's always going to be patient out of pocket. So let's make sure we've got other ways for them to pay for it. And maybe that's a third-party financing, maybe that's an in-office plan. You may have seen a lot of this membership and sort of in-office insurance plans happening. These are great idea because anything that you can do to help that patient get to yes, is gonna result in them more likely wanting to stay in your practice.

Particularly for those who don't have insurance, because they chose you out of anyone else they could have had rather than choosing you from an insurance list. So particularly for your non-insurance patients, make sure you have other ways for them to pay. And make sure you give them the ability to do it at any time, from anywhere. So for example, a patient portal or an app that you can have them log into and pay you even when they're not standing in front of you.

Because you may have talked to that patient about, say, getting started with their treatment, and they were gonna do a down payment on it. And they smiled and nodded, but again, they had to take that treatment plan home and talk to that partner and decide, how much am I ready to put down? Can I do this? Now imagine they make that decision at home and you've already given them the ability, right there in the comfort of their home.
To make that down payment, to get started with that treatment instead of having to call you the next day you're in, figure out how to give you a credit card over the phone, play all those little games. We are an increasingly digital world and we wanna be able to do these things at a time that's good for us in a way that we're comfortable with. We're gonna talk quite a bit about that digital aspect because it is so important to our communication. And the first place I wanna mention that is in follow-up.

Now I know everyone on here who's been to a practice management course has learned the, well, you call a patient, at the end of the day, you have that little list and your office manager, your treatment coordinator may give you as a doctor that list of here's who you need to call. These were our new patients today and these were our big or surgical cases. Those are the folks you always want to follow up with and we all learn that in practice management 101. But I'm going to say this to you, the end of your day, I'm just sitting down to dinner. But I don't wanna take a call from you while the food's still hot. But if you text me, I'm way more likely to respond to that and I'm gonna appreciate it more because you didn't interrupt my lifetime, my family time, just to say, hey, thanks for coming. It's a great thing to do, but let's do it in a way where patients wanna receive the communication.

And I know for a long time as dental practices, we sort of rejected the idea of having to market to the millennials. Well, newsflash for you folks, the oldest of millennials are over 40 right now, putting them in that target audience, the patients you most want to attract. And in fact, for those patients, for the about 40 and under a group, that phone app, that thing you were gonna call them on, is the fifth most used app on their phone.

It's not the first thing they're reaching for because they want the ability to interact in a digital way. They're used to doing it. Whether they're getting a car through Uber or Lyft, whether they're having food delivered, or whether they're booking a beautiful Airbnb for their next vacation, patients want to do things in a time that's comfortable for them, on a device that's comfortable for them. And let's face it, we are increasingly doing this.
Rather than sitting down and typing or picking up a phone. It's just so much more convenient for us to be able to deal with things that are there right in our pockets. More than three in five Americans want their healthcare experience to be like that. They wanna be able to schedule an appointment when they wanna schedule an appointment. They wanna be able to interact with the office when they wanna interact with the office, not when an office is open Monday to Thursday from seven to three.

And in order to keep these patients, in order to convert them into real patients, we need to be having this dialogue with them in the way that's most comfortable for them and in the way that they will truly respond with us. So since we know most of our patients, again, over 60% are looking to have that experience, let's make sure we have something to practice that lets us do that. Let's have a technology that lets us automate some of that.
Whether it's appointment reminders or any sort of alerts or even asking for reviews, all of these things should land in their text messages or their inboxes at a time that works for them so that they can respond and deal with those when they want to. I will tell you, I am one of those guilty people who wakes up in the morning and before I do anything, I pick up my phone and I'm the worst. I scroll through Instagram, because I'm one of those, and I also check my emails.

It's a quiet time before I get up and do anything else where I know I can deal with anything that's a priority or anything that I'm thinking, you know what, let me just take care of this. So it's not gonna weigh on my head the rest of the day. And that's a wonderful time for patients. I'd be one of those to be able to take care of the things we want them to address. Maybe that's leaving a great review. You know, if I wake up in the morning, good and refreshed and I'm thinking, no, I had a really good appointment yesterday.

That's probably a time when I'm going to write glowingly about you, as opposed to when I drove home from my appointment with you and I hit that snarl of traffic and now I'm cranky and irritable. And even though it wasn't your fault, I'm not in the mood to leave a great review. So let's make sure we're giving them that ability to do whenever they want. Now, once they have come for that first appointment and we've shown them that they matter, that they're important, that there's no indifference in our practice, and we're communicating with them in ways that they wanna be communicated with, and we're giving them perfect treatment plans that are written in languages they understand, boy, we better make it easy for them to come back in, right? Now, I know in our perfect world, every patient is gonna walk up to the front desk after that first appointment and schedule their next visit. We all learned that in practice management 101 as well. But we also learned in reality that doesn't always happen. It'd be great if it did.
We know folks have life. Life is a big messy thing, and we wanna help them be able to control our piece of it. So let's give them the ability to schedule that appointment even after they've left. Let's have an ability, and I know our folks, our friends here at Next Health have a phenomenal tool for this. Let's make sure they can schedule an appointment with you when it's best for them at a time that works for them.

We don't know what everyone's life schedule is like, but you know, some folks are happy enough at two o'clock in the morning, because they're night owls. That may be when they're looking at their life and when they want to schedule an appointment. Pretty sure your treatment coordinator is not taking calls at two o'clock in the morning. So let's make sure the patient can do that. And also make it so that it's easy for you. I know in the early days of online scheduling, some doctors kind of panicked at it because they thought.

I don't know that I want patients to just be able to plug in an appointment wherever they want to. I want to be able to have control over that. And the good news is, in almost 2023, that level of technology exists. The folks who are sponsoring us today will be able to tell you that you can customize this down to all the stuff that you want, the hours that you want, the provider they're going to schedule with, and the type of treatment it's going to be. You all learn about block booking in those practice management courses.

So having the ability to customize that so that when a patient does schedule the appointment that's good for them, it's also good for you is an incredible tool to have available in your practice. I wanna make sure that you use all of this technology in a way that seems more human, seems more friendly. I'm gonna apologize right now that that warm welcome photo is missing. Boy, do I feel unprofessional right now. But I want us to make sure that we can communicate with them in the way we want to communicate with them, but that's also good for them. So I want to make sure that when they get to the practice, they're welcomed like people. We're warm, we're engaging. We call them by name. We understand their needs and in understanding their needs we're showing them that we really care what we're saying, I get it. I may tell, maybe telling you, you need the number 30 MOD, but your biggest concern when you walked in was I wish my teeth were whiter.

So yes, let's diagnose the need because that does show that we care clinically, but let's also talk to them about the procedures they came in asking about because that shows them that we care about the whole person. And most importantly, let's have a way to mutually connect. Let's make sure we can reach out to those patients and reach out to them in the formats they like and make sure that they can reach back out to us and communicate the things we need.

I hope that this has been valuable to you. I know my friends here at NexHealth will be happy to talk to you about any of the specifics of the technology we talked about.

Alec Goldman: The first question that came in is, lots of recommendations were made. What is the one most important recommendation that practices should really take away from the many recommendations that were made? 

Laura Nadler: I think the biggest overarching one, and I say this all the time, is we like to think of patients as patients, and we separate that from people because we sometimes forget that those are the same thing. Our patients have the same wants and need as we do. And one of the core ones is that we wanna be acknowledged as a person, we all do as humans. So remember that that person walking in isn't just your 330 MOD, it is a human being who came in with a whole set of feelings, emotions, baggage, wants, needs, joys, sorrows, and acknowledging the person first will probably go further than any marketing technique you could deploy. Because human connection is what we're all looking for. And that's going to turn a blind date into a real patient. 
Alec Goldman:Thanks, Laura. Question two is about metrics. If you can kind of talk about what are the key metrics across the funnel, obviously the goal is to get a patient to actually come back and sit in the chair, but to get to that point, what are the metrics that you're thinking about and recommending to practices to really keep a tight hold of?

Laura Nadler: So for those of you who were on the last webinar, and if you weren't, I recommend, I know there's a link there so you folks can go back and see it. But we actually looked at what that funnel looks like, where we might reach, you know, 1000 people through the website, but it quickly funnels down through the Google search through them actually finding you through them calling and having that first wonderful experience with your practice coordinator.

And sometimes we're only looking at a 2% from outreach initial engagement to butt sat in the chair and listening to what I had to say. So I don't want folks to feel, oh, well, I did all this outreach and I only got two patients. That is not a terrible metric. In marketing, we talk a lot about what's our open rate on emails and all these sorts of things. But I most importantly don't wanna practice to beat themselves up thinking I did all this and I only got two new patients this week who committed and their new patients. That is not a terrible rate because they stayed. That's the most important thing. So focus on the patients who stayed, the patients who became patients of record, and patients who took your treatment plan and decided to go with it. Don't worry about that 98% who didn't come in, but put things in place.

Like we talked about the digital outreach, all of these things can help bring that percentage up for you. If it's easier to reach you, or if it's easier to schedule that appointment, then we can bring that 2% up by giving them the tools they need. 

Alec Goldman: Right on. And we had one last question. Sure. The question is kind of rooted in automation versus personalization. How do you view, just like does technology take away from that patient personalization and the human touch of actually providing patient care?
Laura Nadler: This is a great question and I love this because I've been in the dental space for a long time and I remember at the early dental shows the technology companies had the tiny little, I'm gonna call them the cheap seats. They had those little eight-by-eight booths around the edge that nobody ever went to see. And now those companies have 20 by 20 islands in the middle of the floor. And there's a good reason behind that because technology has come so far because the ability to be human through technology has advanced. In the early days of patient communication through digital means.

You signed up with whatever the company was and you picked the 10 phrases that you wanted them to send out for re-care, a reminder of your appointment. Technology is in a place now that the human element can be very much a part of that communication. You can design the things that you're going to say in your various emails, whether it's asking for a review or confirming an appointment. 

We're not penned in by bad technology anymore. And every day I see that growing. I'm regularly amazed at the things that now look like Susie in the office, literally just texted that patient two minutes ago, instead of that was all set up in automation. So I'm a big fan of where automation has gone. If you dipped a toe in it five years ago, I thought that was awful. I would suggest look at it again, see what's there now, because the ability to be human while being automated has tremendously improved. Just make sure that's the automation you're using. If you've got that old stuff from five years ago, it's probably not really serving you. Make sure it's speaking in your voice.