By Deborah E. Bush, MA 

This blog draws on insights from Dr. Michael Melkers’s 2022 Pankey Webinar, “Managing New Patients in Challenging Times.” While the blog offers a unique perspective, it is informed by the valuable strategies and experiences shared by various dentists during the webinar. For a more comprehensive exploration of these approaches, I recommend watching the full webinar on YouTube. 

Interestingly, the challenges and strategies discussed in the webinar are reflected in a broader industry trend.  

Mature Dental Practices Often Become Overwhelmed with New Patient Requests 

A year ago, I conducted a dental marketing survey for Alatus Solutions, which provided revealing statistics about how independent private dentists seek and manage requests for new patient appointments.  

• Responding to the survey were 474 dentists aspiring to be 100% fee-for-service.  

• We found that 5% were so booked that they couldn’t make new patient appointments for more than 30 days. 

• 15% had new patients waiting more than two weeks.  

• The 5% had stopped paid marketing because they didn’t want more new patients, overloading their schedules, exhausting themselves and their team, and negatively affecting the care they provide. 

Multiple Strategies Are Possible to Control New Patient Flow 

One strategy to control the number of new patient calls tying up the front desk is to stop all paid marketing and rely solely on referrals from patients who truly appreciate your comprehensive care. Another response (which happens frequently) is to screen calls and do callbacks. That’s something I do not recommend as you will see in my “Do and Do Not” section below. Alternatively, some dentists expand the practice by bringing on a new associate or refer new patient inquiries to a like-minded dentist who is growing their practice.  

Dr. Melkers’s online seminar emphasized the effectiveness of prescreening potential patients during live calls and having knowledgeable front desk staff act as gatekeepers. This concept is discussed in more detail below as an effective strategy for managing this challenge.  

Do and Do Not 

• Even when you are overwhelmed with patients, I do not recommend frustrating your loyal patients by screening calls and relying on voicemail to call them back. Do pick up as many calls live as possible. 
• You can turn off your paid ads, but don’t ignore your website or your Google business page. Your digital presence is necessary to sustain your practice. And the referred prospective patients (who are most likely to be prequalified for comprehensive care) will be curious to see your persona, credentialed expertise, and reviews before reaching out for an appointment.  
• Do keep your website and Google listing frequently SEO-refreshed and up to date with your services. The current Google algorithm prioritizes Quality Content, Mobile Utility, and Local SEO (location, business hours and contact information visible and consistent across all platforms). 

The New Patient Funnel 

The new patient funnel is a metaphor for a potential patient’s journey from initial contact to becoming a regular patient. The stages include: 

• Awareness: The patient learns about your practice through marketing, referrals, or online research. 

• Consideration: The patient evaluates your practice and decides whether to call to discuss scheduling an appointment. 

• Conversion: The patient schedules and completes a new patient exam. 

• Retention: The patient becomes a regular and ongoing part of your practice. 

The funnel helps us conceptualize the flow of interactions we can control. When you have a “leaky” funnel, potential patients fall out near the top of the funnel before being qualified. This can occur if the front desk does not answer calls live or fails to return messages. A lack of training in optimal call handling contributes to this failure. 

​​​In ideal scenarios, receptionists are initiative-taking and well-trained in moving new patients through the funnel or onto a more suitable path for finding the type of dental care they want. However, according to Patient Prism’s AI evaluation of over 50 million new patient calls over the past nine years, more than 80% of the U.S. dental practices participating in Patient Prism’s AI evaluation do not benefit from such attentive phone handling until their performance is tracked and new behaviors coached.  

Prescreening Patients: Identifying High-Quality Candidates 

Prescreening is an effective strategy for managing the new patient funnel. By asking targeted questions during initial contact, your team can determine which patients fit your practice well.  

My Notes for Call Receptionists: 

• Understand Their Needs: Ask, “How may I assist you?” and engage in a conversation to understand the patient’s dental needs and expectations. 

• Set Expectations: Explain the benefits of a thorough examination, the process, the time involved, and the fees. Assess the patient’s willingness to commit to a comprehensive exam, consultation, and finding solutions for their current problems. 

• Note Previous Dental Experiences: The caller’s freely offered comments about their dental history, health history, or concerns about dental care are revealing, but be careful of assumptions based on your biases. Stay in the conversation long enough to understand the person on the other end of the phone. It’s okay to simply say, “Please tell me more.” And, if the caller seeks a “Pankey dentist” because they are accustomed to the highest level of comprehensive care, note that this person has prequalified themselves for your practice. 

• What to Do When in Doubt: If you are unsure, saying, “Our schedule is full right now,” is okay and not impolite. Continue with, “I need to consult with my supervisor to determine if we can fit you in. May I put you on a brief hold or call you back in a few minutes?”  

• Complimentary Consultations: Offering complimentary consultations is a common practice for implant and clear aligner services, but the front desk of a busy practice must prequalify patients for those appointments, or the dentist will spend a lot of unpaid time prequalifying the patients herself or himself. 

Make Room for the New Patients You Want 

Even highly qualified patients may become frustrated if they wait more than a week for an appointment. Consider reserving one extra patient slot per week for the type of new patient you want. If no such patient calls early in the week, use the slot for an existing patient who needs attention. You can also modify your new patient protocol to offer this person a shorter appointment to get started–with the recognition that there will be more than one appointment to complete the new patient process. 

Coach Your Front Desk 

If you have an inexperienced or new receptionist answering your phone, it’s important to discuss with them the types of high-value patients they should prioritize for you. Additionally, provide guidance on how to nurture these new patient leads, so they are more willing to wait for an available appointment. This is a Team Meeting Topic every fee-for-service dental practice should discuss periodically. A high-value patient to you is likely one who wants the highest-level of comprehensive care, appreciates your approach to patient-centered care, and eagerly wants you. 

By Paul A. Henny, DDS 

Times change; that’s for certain. When dental advertising was first allowed in the 1970’s, there was much discussion around whether marketing a dental practice was ethical. Today, marketing ethics is an issue for dental licensing boards to decide, while most dentists have moved on to focusing on HOW to best market their practice. 

Combine this new marketing-oriented mindset with the internet, and there’s a lot of confusion, wasted time, wasted money, and wasted energy. 

Why? Because most marketing efforts are focused on bodies and not people with feelings, priories and values. To quote a popular marketer in dentistry today: “In the end, the only thing that matters is how many butts you put in the chairs.” Really? And as a result, too many dentists are hung up on paying attention to the wrong metrics: ad clicks, social media likes, a high search engine results page (SERP) ranking, new patients per month, and so forth. 

It’s nice to have lots of visitors to our website (and important), but the best question to ask is: Why are prospective patients visiting our website in the first place? The answer speaks to FIT: Is this person likely to be a good fit with our practice Mission and Philosophy? 

If the person fits in with our practice’s Mission, then we’re supporting our Philosophy and moving toward our Vision. If the person doesn’t fit in with our practice’s Mission, then we aren’t. It’s that simple. 

If the person fits, they’re much more likely to schedule an appointment. If the person is a good fit, they are much more likely to be open to a proper and thorough examination process. If a person is a good fit, they’re more likely to make good decisions regarding their dental health. And if a person is a good fit, they are much more likely to agree to appropriate treatment plans. Consequently, when most people in our practice are a good “fit,” our schedule is full of folks who show up, and are grateful they found us. 

The key to successful marketing of a health-centered / relationship-based practice therefore begins BEFORE each person visits our website and therefore BEFORE they call. And that’s all related to our reputation—what’s commonly called our “brand.” Our brand is the set of expectations the person has about us. 

So, it’s important to know who they are, what they are seeking, and how we can best address it. Knowing the answers is where marketing should begin. On this, Peter Drucker famously said, “True marketing starts out with the customer, their demographics, their realities, their needs, and their values. The aim of marketing is to make selling superfluous. The aim of marketing is to know and understand the customer so well that the product or service fits him or her so well that it sells itself.” 

And that represents a whole lot more than just getting a “butt in the chair.” Mastering person-centered marketing is a key element to realizing our dream. Failing to understand it forces us to try and manage people who aren’t a good fit—sometimes multiple times a day, and that simply isn’t very fun or rewarding. 

By Phillip Gold, Master CDT 

At a lecture in Atlanta a few years ago, Dr. John Cranham told us about a patient who had been in his practice for years and mostly came in for hygiene and emergency visits. She moved out of town for about a year and then returned to their dental practice. 

She made a hygiene appointment and when John walked in to greet her, he saw a woman with a beautiful smile. He was almost speechless. When he gained his composure, he remarked on the beautiful dentistry she had achieved while she was away. He asked her what got her excited enough to get the work done.  

She said, “I’ve always wanted to do something like this but I didn’t know who could do it.” When he explained that they do dentistry like this all the time she said, “I had no idea, I thought you only did emergencies and patch work.” 

How do you rebound from that? You make it a lesson learned and one you do not want to repeat! 

How do you spread the word?  

• Website Communication: 

Your practice website serves as a virtual front door. Make sure it clearly communicates all the services you provide. Consider creating separate pages or sections on your website dedicated to each service. Provide detailed information, FAQs, and before-and-after photos to show your expertise. 

Don’t fail to inform them of payment options that will make it easier for them to afford the dentistry they desire. 

• Smile Galleries and Visual Displays: 

Smile galleries in your office can be powerful tools. Display before-and-after photos of actual patients who have undergone various treatments. Seeing these transformations can inspire curiosity and interest. Also use photo books or digital displays in your reception area to showcase successful cases. Patients waiting for their appointments can browse through these visuals and learn about available services. 

• Social Media Engagement: 

Leverage social media platforms to highlight your services. Regularly post content related to different treatments, patient testimonials, and educational videos. Share success stories, patient experiences, and behind-the-scenes glimpses of your practice. Encourage patients to follow your social media accounts to stay informed. 

• Team Training and Communication: 

Train your team members to discuss services confidently. Encourage team members to engage in friendly conversations with patients. When patients ask questions, provide informative answers and emphasize the benefits of specific treatments. 

• Handouts and Placards: 

Create simple handouts or placards that outline your services. These can be placed in the waiting area, treatment rooms, or given to patients during their visits. Include brief descriptions of each service, along with any special features (e.g., same-day services).  

• Educational Events and Seminars: 

Host occasional events or seminars at your practice. Invite existing patients and potential new patients. Use these events to discuss different treatments, demonstrate procedures (if possible), and answer questions. It’s an excellent opportunity to engage directly with patients. 

Remember, patients often don’t realize the full scope of what a dental practice can offer. By proactively sharing information, you empower them to make informed decisions about their oral health. 

By Lee Ann Brady, DMD 

When you are managing the care of an older patient, I encourage you to take time to look up their medications and the medication you are considering prescribing, even something as simple as antibiotics or pain medication. 

A resource I use when I am writing prescriptions and also managing existing pharmaceuticals that my older patients are taking is the Beers Criteria published by the American Geriatric Society (AGS). The AGS Beers Criteria® lists the Potentially Inappropriate Medications (PIMs) that are typically best avoided by older adults in most circumstances or under specific diseases or conditions.  

Some listed PIMs should not be written for people over age 65 and some are okay with caution or in moderation. There is a long list of medications people can take until they are ages 65 to 70 without a problem. After that age, there are side effects. 

Some of the medications cause adverse reactions on their own or in interaction with other medications. Some of these PIMs are common over-the-counter antihistamines. 

Gary M. DeWood, DDS, MS 

Many dentists believe that provisional restorations don’t really matter. After all, they are not really a stand-in for the final restoration. I would respectfully disagree. I am a proponent of creating functional, durable, and highly esthetic provisional restorations, every time. They have the potential to impact your dental practice a lot more than you might think. Whether you print them, form them, or free-hand them, a GREAT temporary is a great billboard for your practice. 

1. Make the provisional as Esthetic as the final restoration.

I contend that the more your provisionals look like what you are hoping for when you seat the final restorations, the more people will talk about them, AND you. 

I was able to build a referral restorative practice by creating provisionals that made patients want to come to my practice and specialists want to send people. For much of our career, almost the entire team of the oral surgery office we worked with, and many of the team members from the other specialty practices we worked with, were our patients in Pemberville, Ohio. 

Front teeth or back teeth, when you make them look like teeth, people will like it and they will show and tell other people. “This is just the temporary?!” was not an uncommon question or exclamation from our patients.  

2. A GREAT guide makes a GREAT provisional restoration.

Your wax-up** cast/model serves as your vision, as your preparation guide fabrication device, and as your provisional former. When the preparation is appropriately reduced for the material selected, the temporary can mimic the restoration. 

** The wax-up might be created with wax then duplicated with impression material and stone to create a cast, or it might be scanned to be duplicated with resin and printed or milled to create a model. 

3. 3. Use that provisional to highlight the talents of your team members.

You might LOVE to make those provisionals, but if your assistant is equally excited when it comes to recreating nature for the patient to appreciate, then it could be an opportunity for patients to see that your assistant does much more than set-up, clean up, and hand you an instrument. My dental partner, Cheryl, (who is also my wife) and I actively sought out things that could help our patients experience our team as much more than our helpers. 

As we all know, dental assistants are an integral and vital part of what the practice is and are a powerful force in how and why patients ask for dentistry. Assistants who fabricate provisionals have an opportunity to be seen differently, and we were always looking for ways to create partnership with them in our treatment. 

4. 4. Take pictures of them.

Photographs of the temporary will make it easier for the lab to design the outcome. They will be able to see what you are thinking, able to visualize what you want, AND maybe even more importantly, see what you do not want. With anterior provisionals, I have frequently noted to my ceramist, “Please put the incisal edge in exactly this position vertically and horizontally in the face, then use your artistry to create the tooth that belongs in the face you see in the photographs of the patient before, prepared, and temporized.” 

There were many times when the technician was able to see and create effects that I might have not recognized as being “just the thing that would make these teeth extraordinary.” And don’t forget to show the patient the photograph. 

5. 5. Love the material you make the temporary with.

The better the provisional material is at holding tooth position and functional contact, the less adjustment we’re going to have, so using a high-quality material is important. There are a lot of them out there. I like bis-acryl materials that polymerize with a hard surface, have little or no oxygen inhibited layer, and can be polished easily. The polish is more about feeling smooth than about the shine. Ask you patients how their provisional tooth “feels” when you are done, so they sing your praises. 

6. 6. Use high-quality core material.

When you use a good core material the prep will be smoother, making it easier to fabricate nice provisionals. Ideal prep form goes a long way toward better provisionals. 

7. ASK your patient to tell people.

As noted above, when you can elicit an emotional response about the awesomeness of your provisional, ask the patient to tell other people, “….and this is just the TEMPORARY!” 

Charlie Ward, DDS  

Whether you want to use a digital SLR camera for documentation, patient education, lab communication, making presentations at dental events, dental publications, or accreditation in the American Academy of Cosmetic Dentistry, you have choices to consider in multiple price ranges.  

Dentists can spend $1,800 and get a good system for documenting cases, patient education and lab communication. Dentists can easily spend $3,800 or more on a setup to equip themselves to take higher quality images. 

Camera Body: Most dentists shoot with a Nikon or Cannon DSLR camera. These are comparable brands. My experience is with Canon but my lab technician uses Nikon and gets wonderful results. I am shooting with the Canon EOS 90D. The comparable Nikon is the D7500. More entry-level models are the Nikon 3500 and the Canon Rebel T8i. 

Lenses: We can get a third-party Sigma 105mm or a Tokina 105mm lens that gives us decent quality, or we can purchase the Canon 100mm or Nikon 105mm version at twice the price. When I upgraded to the finer Canon lens, I noticed a huge difference in image quality. I recommend an upgraded lens for the highest-quality images you need for accreditation. 

Flashes: The ring flash is a great entry-level option and significantly less expensive but there are limitations to what you can do to control your light. I’ve been using a dual point flash for some time. I can pull a flash off and shoot from a different angle. By changing where the light is coming from, I can accentuate the angle lines for more depth and visual clarity.  

Sometimes, I’ll take one of my flashes off, hold it on the opposite side of what I am shooting, and shoot the flash back into the lens of the camera. When I do this, I get an ethereal-appearing image or an image with a white background. I appreciate the versatility of using the dual point system.  

For my best-looking images and portraits, I’ll use softboxes. This gives smoother, more diffuse light and a beautiful appearance. These are necessary for everyday dentistry but make a huge difference in showcasing aesthetic cases.  

Consider the Long Term: When dentists invest in cameras and lenses, they typically use them for a long time. If you are on the fence about how much you want to invest, my own experience might be helpful. I honestly wish that I had upgraded sooner than I did with the Canon EOS 90D and the Canon 100mm lens. After taking photos for 12 years, the upgraded equipment has only increased the joy I have for photography and pushed me to take more pictures! 

Dental Sleep Medicine in Restorative Practice Part 9: Marketing Dental Sleep Medicine 

By Todd Sander DDS 

How do you start reaching out to physicians and other providers to build a dental sleep medicine practice? Start with the ones you know. Start with your own personal physician and start a conversation. If your dental patient is on CPAP, get permission to converse with their doctor. I spend time contacting many primary care doctors and find they are the ones who know patients are non-compliant with their CPAP therapy. They help me get patients re-evaluated by a sleep specialist. 

This may not be true in your community, but in Charleston, SC, where I practice, many primary care doctors don’t know what to do with their non-compliant CPAP patients. They are thrilled to have someone to refer them to try alternative therapy. 

Years ago, I reached out to sleep testing centers to communicate my services. Both independent sleep labs and hospital-based sleep labs have been great sources of referrals. For many years, I was the dental advisor to a sleep lab. A great conversation starter with sleep physicians, is the potential of combining CPAP and an oral appliance. This often allows the CPAP air pressure to be turned down so their patients be more comfortable and compliant. 

When you screen your dental patients for airway issues such as sleep apnea and snoring, the next step is referring your patients with issues for a sleep study. When the patient discusses their symptoms with their primary care physician or a sleep physician, you are mentioned and often documented as making the referral. Over time, physicians come to know you as a go-to provider of dental sleep appliance therapy. This process is sped up when you take the time and initiative to contact your patient’s primary care physician with your patient’s permission. You can guide physicians and remind them of the recommended standards-of-care, including appliance therapy in place of or in combination with CPAP therapy. 

Some patients self-refer to me, as friends and family talk about their experiences in my office, but I am not spending money on digital advertising to bring in dental sleep medicine patients. Mostly, they are referred to me by physicians, dentists, and other patients.  This is the same for my dental practice. 

As mentioned in a previous part of this series, our hygienists have attended dental sleep medicine courses with me and screen for airway issues. They adeptly educate and guide patients who have signs and symptoms to schedule an examination and consultation with me. 

Note: When patients are referred to me for dental sleep medicine, I never encourage them to become dental patients in our practice. This is a choice they might make but I am extremely careful to refer patients referred by a dentist back to their referring dentist for all dental needs. I am an adjunct to help other dentists’ patients fulfill a prescription for a dental appliance. 

If a patient comes in for sleep-disordered breathing but is also experiencing facial pain or TMD, I understand that this patient’s two issues are likely connected and I will not be able to successfully treat one without treating the other. This is an opportunity to communicate in depth with the referring dentists and let them know I plan to treat the patient for both issues simultaneously. This has been easier for me to do because I have had years of experience in treating facial pain and TMD issues in my dental practice, as well as sleep apnea and snoring. 

Seth Godin recently asked, “What are the symptoms of a marketing problem?” and continued… 

We have a ‘marketing problem’ when: 

• There are people who would benefit from your work who aren’t engaging with you. 
• There’s a change you seek to make in the culture, but it’s not happening. 
• You’re having difficulty persuading other people of your point of view. 
• The service or product you make isn’t resonating with those you seek to serve. 
• You’re fighting in a race to the bottom, and it’s wearing you out. 

If you have a marketing problem, how much time are you spending working on a marketing solution? …You can’t solve your marketing problem tomorrow by simply repeating what you did yesterday. 

At the Root of Your Problem

Broaden your thinking and consider what is at the root of why you aren’t doing more of the dentistry you want to do and building a larger base of patients you enjoy. There are two primary reasons why dentists fail at meeting their desired practice goals: 

1. They’re not very good at delivering on the promise, and therefore aren’t getting very many internal referrals and excellent digital reviews. (Marketing doesn’t solve this. Other things do. This isn’t really a marketing problem, is it?) 
2. They are not well known in their community for being the genuinely caring and “honest” type of dentist that patients crave most. And they are not well known for being the perfect fit to compassionately and predictably solve complex oral health problems to significantly improve quality of life.  (Marketing can help solve this, but how?) 

Resolving Your Problem

Most dentists naturally focus on developing their skills and then struggle in the shadows with an amazing skill set that few people seem to appreciate. How do you best approach resolving issue #2? That depends on what it is that you’re trying to achieve. What is your purpose? And what are the principles and philosophy that stands behind that purpose? Because it’s your principles and philosophy that you need to be promoting and projecting out into the public sphere, not just the flash…not just the “how to”…and certainly not the doctor dancing around the office and bragging about how great he or she is.  

Patients need to be genuinely impressed and more than satisfied so they spread high praise in your community. You and your entire care team need to give them things to talk about…what it is different about your approach….the relationship they have with you…the experience they have in your office…how well they are informed…the excellent results they enjoy…  

Clearly speak about your principles and philosophy in mindful, emotionally intelligent conversations with patients. Clearly write about your principles and philosophy of practice on your website. Listen and read “well” what patients say about you. What do they love? This is significant content for your website, blog and other external marketing.  

It comes down to: What is it that you can do that is deeply significant to your target audience, and how can you best convey that information and feeling to them on a consistent enough basis that they want your care?  

The foundational, solid relationship you build with them using highly attuned emotional skills will support treatment acceptance congruent with what they value and congruent with what you explain is in their best interest to meet their oral health and smile objectives. 

That’s what marketing is about, and it is both an internal and external process that must be constantly fine-tuned and consistently evolving within yourself, within your interactions, and within your messaging inside and outside of your practice walls.