Jerry Jones — How to Create a Cash-Flow Surge Within 7 Days or Less

Guest Column — Jerry Jones helps solve a pressing problem for dentists
Jerry Jones is a relatively new friend of Prosperident, but his focus on marketing and ability to think outside the box intrigued us.  So We are pleased to welcome Jerry as a guest contributor.  Here are Jerry’s ideas on producing an immediate cash flow improvement, which is something many of our clients can benefit from.
Jerry’s web site is here.
How to Create a   Cash-Flow Surge Within 7 Days or Less
If you have your team implement what I am about to share, you’ll experience a cash flow surge in your practice in a matter of days.
In fact, the results have helped thousands of dentists I’ve worked with over the last 20 years get through tough cash flow crunches on more than one occasion. And, once you get the system in place, you can repeat this process once or twice a year and it can become part of a regular routine.
What I’m talking about is patient reactivation.
Inactive patients are a part of every practice – and it doesn’t matter just how great your team is at keeping patients active in your practice. In fact, here are two routine experiences every office has:
1.) Patients leave your office with a scheduled appointment and later cancel it. And this is where a lot of practices lose track of patients. Eventually, enough time lapses and even the patient forgets or willingly puts off calling back to schedule.
2.) There’s a system break-down (or lack of a system) and patients are not scheduled for a “next” appointment either by the DA checking them out, the hygienist or the front office person. In my office, Wellness Springs Dental® of Salem, the clinical staff makes the next appointment while the patient is sitting in the chair. An appointment card is filled out and provided to the pt. In hygiene, our patients fill out their own reminder postcard (oldest trick in the book, right?). You might think this is happening in your office, but have you checked recently? Have you physical proof?
In both instances above, that forgotten patient fits my definition of an inactive patient – someone lacking a next appointment. If they have no next appointment, how can you possibly call them active?
You see, dental practices offer one of the few professional, medical practices that offer the opportunity for continuity revenue. Physicians don’t have this luxury unless they’re doing injectables (Botox, etc.). In chiropractic, patients usually have a defined term of treatment that might only last weeks or at most, months. Shoot, even non-medical pros like attorneys, rarely have a business that require regular visits. CPAs are an exception. They usually hold on to their clients for a long period of time due in large part to the high pain level of disconnect.
In dentistry, we set up our patients to visit us every 3, 4 or 6 months (if you have a strong soft tissue management program, you probably have as many 3 month visitors as 6 month).
It’s a great model that promotes my favorite kind revenue: recurring revenue. Until that is, a patient falls through the cracks as in the instances above, and are without that next appointment.
Now, you might be saying at this point, “Jerry, so what? So what if I have 500 patients that are inactive and without a next appointment. Is it reallyworth all the trouble?”
YES. It’s absolutely worth the trouble. Here’s why:
First, it’s far easier to get treatment accepted by someone you have a relationship with, especially if they have treatment you’ve prescribed. It’s easy for your staff to use that prescribed treatment as a lever to increase “compliance” for those who’ve not been in to get treatment started (or finished), or, to get that check-up. Remember, they already, theoretically, know, like and trust you.
Second, it’s far easier to get a buyer (your patient) to buy again vs. going to the expense ($100 to $500 or more per new patient) of attracting a new patient and then take the time to develop a relationship and trust.
(Incidentally, increasing the frequency of visits/purchases of both inactive and active patients, is one of the easiest ways to increase your cash flow!)
So we’ve discussed the definition of an “inactive” patient, we’ve covered how patients fall through the proverbial cracks, so let’s take that next logical step and review the best way to reactivate these lost souls.
Step 1: Identify them. Run a report in your practice mgmt. software that tells you who does NOT have a next appointment. If you’re unsure how to do this, contact your software support. This is really critical and can save you hours of time. Otherwise, the back-up plan is to go back month-by-month and look at every patient that should have a next appointment. This is arduous, but, don’t discount it as unnecessary if you can’t get the report you want or something similar.
Step 2: Export the list to a format compatible with Excel, so you can edit, update and have easy access to phone numbers and emails.
Step 3: Create a “campaign” that your staff will follow-through with that will get these folks from inactive to active status.
After doing this for a couple decades, we’ve devised a simple formula for this reactivation campaign. It should consist of the following:
  • A personalized letter sent in a hand-addressed envelope with a “live” stamp
  • A postcard – hand-written
  • A phone call – personal, not using voice broadcast
  • An email or text message – personal, not an email broadcast
  • Final personalized letter
If you’re familiar with a “dunning” campaign, this is similar. Each contact with the inactive patient becomes more urgently presented. The first contact is casual. The postcard more urgent. The phone call, more so. The email or text or both, still more and then a final letter that explains the doctor is really concerned and at this time, you’ll leave it up to them.
My friend and Member, Dr. Chris Griffin of Ripley, MS, goes so far as to send a faux dental chart in the mail with a hand-scribbled note from him to his staff that the patient sees inside. The note conveys just how important that next appointment is and how concerned Dr. Griffin is over this patient being inactive.
All of these steps and the 100s of variations you could add, get the patient to understand just how important it is to get back to the office and get reactivated. (We also have articles written for patient newsletters that explain how to avoid becoming an “inactive” patient.)
You might also be wondering why we use direct mail, a phone call and email/text. Good question. The biggest reason: not everyone responds to the same media. So, by using different media/ways to reach them, you’ll actually reach more of them. So, skipping steps or attempting to get away with just a letter or just a phone call will inhibit your results.
The steps I mention above should be spaced no more than 7 to 10 days apart. All in, a campaign from start to finish should span no more than 60 days. Preferably, 45 days at the most.
I’ve had members tell me they’ve taken their inactive patients from as far back as five years, and had success reactivating them. (If you do this, reach out to me and I’ll explain how to avoid wasting hundreds of dollars or more, on postage and printing, by making sure you have your patients’ most recent addresses – since roughly 30% of your patient base moves annually.)
Is there some work involved? Yes. Of course. But, it’s work that has a direct, measurable, very fast payoff. What’s more, your patients will actually thank you for reaching out to them. They forget. They get busy. And, because dentistry is such a small slice of their life, often, unless pain is persistent, they’ll delay and, eventually just forget.
Do yourself a favor: get your inactive patients identified and reach out to them now.

Jonathan VanHorn — The Fifteen Numbers that Will Make (or Break) Your Dental Practice

Introducing Jonathan VanHorn
Jonathan VanHorn is certainly an interesting guy.  He is a CPA, but has moved beyond the traditional CPA bailiwick of “historical” work like P&Ls and income tax filing.
Jonathan has founded a company called Dentistmetrics and now uses his considerable financial knowledge to help dentists improve their financial outcomes.  The following is an article that he wrote for our newsletter.  Welcome, Jonathan!
The Fifteen Numbers that Will Make (or Break) Your Dental Practice
I finished a goal setting session with a client this morning, and as we were wrapping up my client said to me, “If I’d set these plans in motion five years ago, I’d be taking home nearly $15,000 more a month right now.  If only I had known what I didn’t know.”
Many dentists know that “stats,”“benchmarks”, and “KPIs” exist, but don’t know where to start looking for improvements.
This article covers three of the most important numbers I’ve compiled through my time as a dental coach and dental CPA.  These numbers should give you a starting point for your practice.  I’ve looked at a lot of dental practices and the practices that have mastered these numbers are typically the most successful in terms of profit.
I do want to emphasize that averages apply to everyone but no one at the same time. What does this mean?  It means don’t immediately get upset over your performance if you look at these stats and are underperforming.  It also means that just because you meet these three numbers, you aren’t guaranteed to be maximizing your potential.
The Three KEY Numbers for any Dental Practice
But wait, the title is “Fifteen” not “Three”! What gives? I’m only able to share three of these numbers in this article, BUT, if you’d like to see a free report with more than fifteen of these same statistics, including a mini-guide with precise information on how to really get value out of tracking your performance, visit a copy of the full report.
#1 – Wages and Salaries including payroll taxes benefits (not including associates, or owner’s expenses)
Goal: 25% of net productions.  If you have stable and consistent earnings, you can use collections, but net productions are a better indicator overall.
Subgoal: Of the 25% compared to net productions, around 1/3rd should be hygiene. (around 8% to net productions)  That leaves 17% for the office manager, the front desk, and dental assistants.
Subgoal: For every $35,000 in monthly collections, you have one front office staff.
Where you should look if you don’t meet the standard:
  • Are you overstaffed?
  • Are you overpaying your employees?
  • Is this a production problem?
#2 – Dental Supplies
Big Picture Goal: 5% of net productions.
This can vary a bit depending on the services you offer.  But 5% is where you should set your sights.
If you need help on lowering your supply costs, I wrote a set of posts covering this exact topic which you can find here: How to lower your dental supply costs.
#3 – Hygiene Rule of Three:
·        Hygiene should equal 1/3rd the production for the practice.
·        Hygiene should be compensated at 1/3rd production.
·        Less than 3 hours a week unscheduled/canceled hygiene scheduled per hygienist. (also called open hygiene)
If you don’t meet the standard:
  • What is your average daily production for each hygienist?
  • What is the average production per patient seen from each hygienist?
  • What is your recall efficiency? (How many hygiene patients reschedule?)
To recap:
The three base numbers every practice should keep track of are the three big picture stats here.  If you keep these numbers in line, you will have the basis for a fantastic practice.  However, this isn’t the end all be-all of every practice.
If you want more stats, such as:
  • The baseline goal per day for each hygienist.
  • The goal for each hygienist’s service.
  • How many new patients a day you need to aim for.
And more than 13 other KPI’s for dental practices, along with a step by step guide of how to look at these numbers check ou t for a full report.

Gary Takacs — 5 Tips to Make This Your Best Year Yet


For more information please visit Gary’s website

Many of you know or know of of this guest columnist.
Gary’s Takacs’ bio states that he is a practice advisor, speaker and founder of the Thriving Dentist Show, the #1 dental podcast on iTunes.
Prosperident CEO David Harris was privileged to be a guest on Gary’s show — you can check it out here.
David made the following comment about Gary that suggests that his bio is a bit understated:  “In addition to being a great interviewer, Gary is clearly one of the brightest minds in dentistry today.”  David is a Mensa member himself, so coming from him this is indeed high praise.
Let’s see what Gary has to say.
5 Tips to Make This Your Best Year Yet

It’s my strong opinion that dental practices are either growing or they are in decline. A case could be made that there is a third option of staying the same, but with ever-rising overhead, staying the same is just another form of decline.  This article will share 5 specific tips that will help you make 2014 your best year yet!

Develop a Comprehensive Marketing Plan            
New patients are necessary for a growing practice and often times the difference between a good practice and an amazing practice is the volume of quality new patients. Spend some time this year crafting a comprehensive marketing plan that includes internal, external and digital marketing activities. In my own practice, our most effective internal marketing strategy is the Dentist calling all new patients and any patient who receives an injection on the evening of treatment. An effective external marketing strategy for us is making NFL-Quality mouth guards for our local high school football team. One very effective external marketing strategy for us has been getting online patient reviews. An appropriate marketing budget for a growing practice is 4-5% of revenue.
Embrace Whitening              
Growing your whitening business is a great way to create better patients. Here are 3 simple things you can do to grow your whitening business:
1)     Take a shade match at the beginning of the hygiene appointment. Then show the patient their current tooth shade on a shade guide organized chromatically from dark to light.
2)     Value price whitening. Consider value-pricing whitening as a means of making it more affordable and accessible for your patients. The real economic benefit is the restorative & elective treatment that results from increasing your whitening.
3)     Offer lifetime whitening. Consider providing your whitening patients with free gel provided they keep their recommended hygiene appointments. This is a win/win strategy that patients love!
Use Digital Photos for Patient Education   
Take the following series of 6 digital photos on all new patients:
  • Natural smile
  • Close up retracted view
  • Upper occlusal view
  • Lower occlusal view
  • Left buccal corridor
  • Right buccal corridor
Load the photos onto an iPad or tablet for patient viewing. This will convert the process from a passive process to an active process for the patient. Be prepared to hear two frequent comments from patients; 1) “Wow, I have never seen my teeth like this before”, and 2) “Yuck!”
Add Clinical Services             
Adding clinical services is an excellent way to grow your practice. Existing patients already know and trust you and will likely respond well when you introduce additional services. Some services worth considering are; Adult orthodontics (6 Month Smiles or Invisalign), Implants, Sedation dentistry and Treatment of head and neck pain (TruDenta).
Provide a Remarkable New Patient Experience     
The first visit to your practice should be an awesome new patient experience that helps the patient take a greater interest in their oral health. Take some time with your team and design a new patient experience that is ideal. Consider beginning with a simple office tour that shows the patient some services that are available in your office. Include a new patient interview where a team member takes the time to get to know your patient and understand their ‘dental story’. Make it a ‘wow’ experience where patients leave saying, “Wow, I have never been treated so thoroughly before!”
Consider the 5 tips presented in this article as an excellent way to make 2014 your best year yet. As you begin to implement these recommendations, think of the following axiom. To achieve what you have never achieved, you must do what you have never done. Here’s to your success!

Kristin Pelletier — Overcoming the Insurance-Driven Patient

Learn more about Kristin at

As you know, in the course of our work we are blessed to encounter some truly amazing consultants, and we like to use this portion of our newsletter to showcase some of them.
This week’s guest is someone we feel is an emerging star in the dental consulting world.
Kristin Pelletier is a dental practice management consultant whose comprehensive services bring success and transformation to clients with her results-driven consulting style.
We have known Kristin for several years and she continues to impress us with her knowledge and logical approach.
Overcoming the Insurance-Driven Patient
Many dental practices tell me their number one obstacle to case acceptance is that their patients are insurance-driven. What exactly does this mean? When you’re presenting treatment to a patient, how often does the question “Will my insurance cover this?” come up in the conversation? And, when it does, are you prepared with an effective response, or do you simply take the patient to the insurance coordinator to get the answer?
While many practices think this focus on insurance is initiated by their patients, I believe most patients actually learn this behavior from the dental team. Patients absorb this message in your office every day by offhand questions such as: “How often does their insurance company allow full mouth x-rays?” Or, “Will their insurance company allow sealants?” Or, in the case of a restorative procedure, do you recommend that the patient spread the treatment over multiple benefit years to get the maximum coverage by insurance?
When patients hear us asking these questions, they think that treatment decisions are the responsibility of their insurance company. Instead, we should be communicating that our primary concern is our patients’ optimal oral health. I recommend that you have a team meeting and talk about what types of services your practice makes treatment recommendations based on insurance coverage. Then, consider these same services in terms of their impact on your patients’ oral health without regard for how much insurance will cover. What changes do you need to make in the language you’re using in your practice so your focus is on patient health not insurance payments?
Don’t just make these changes with bigger procedures. Make sure to incorporate this language in everything you do. Your patients will start to pick up on the message for the little things – the preventive and the diagnostic procedures – that this practice focuses on what we need and not what insurance allows. Then when something bigger comes up – like restorative procedures with a waiting period or a frequency limitation – your patients have already been sent a very clear message that your practice makes treatment recommendations based on what you need not what insurance allows.
When objections do come up, reply with a health-centered answer. Take them back to the consequences of leaving the condition untreated. One of my favorite responses is: “Insurance is designed to help you maintain a healthy mouth. If you need a restorative procedure or you need to go from disease to health, insurance only provides a minimal cushion to help. But, once your mouth is healthy, your insurance will help you keep it that way.” When the dentist can be the one to say this, it is so POWERFUL!
When you change this behavior in your practice, you’re on the way to training your patients to value what they need and not what insurance will pay for.