In this episode, Dr. Tom Orent, gives us a behind the scenes view of his 20, 20, 20, new patient exam process. Dr. Orent notes that there are 3 main rules when talking to a asymptomatic patient and discussing treatment:
It's important to remember that new patients will most likely be sensitive to all three of these points when undergoing treatment or treatment planning. Dr. Orent recommends a more gentle approach when immediate attention isn't required. He takes his patients through phases rather than overloading new patients with worries of payments, time, and pain. Phase one of Tom's 20, 20, 20, process involves the lower ticket items that the patient needs, and eases into later phases with more comprehensive treatment.
Listen in for more tips from Dr. Tom Orent on higher treatment conversion rates, happier patients, and profitability.
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Michael: Hey Tom. So talk to us about patient retention. How can we utilize this, or what advice or suggestions can you give us that will help us with this? .
Tom: looking at new patient retention, uh, it, it's critical, but before we get into how to do it, let's talk about why you'd wanna do it.
Mm-hmm. , why is it so important? Why is it critical? Let's say a healthy new patient flow for a GP is 25 or 35, let's say per month. So I dunno, about 400 patients, new patients a year, The average lifetime value of a new patient in a, in a general practice is over $6,200. So that's a lot of money.
Lifetime value for each one who comes in and. . if you could only increase new patient retention, let's say just by 20%, that's 80 more patients a year who are with your practice times, however many years are gonna be there. That one year. Those 80 patients, the average lifetime value multiplied out, you're looking at just shy of 500,000.
That's a half million dollars increase in the value of the practice over a few years. So we're gonna talk about something that I call the twenty twenty twenty new patient exam. Uh, before I get into detail on how to. , let me tell you who this is not for, cuz it's really important that I make this clear even before I tell you who it's not for, we're talking about the most common kind of patient, the asymptomatic, no symptoms comes into the office.
I think everything is just fine. I'm just here for a cleaning and a checkup. if the patient has an emergency, if the patient has a broken tooth, if the patient says I need a mile reconstruction, that's a different. what we're talking about today is retaining the vast majority of the highest likelihood of the patient coming in, and those are the people who say, yeah, I think I'm just fine.
All right, so who, this is not for, if you have the gift that Gordon Christensen or Pete Dawson or John COIs or Frank Spear or, or any of those guys where they can just meet a new patient who has no symptoms, thought everything was fine, sees that they really do need massive work, and within, you know, a short period of time on that first.
You're able to get across to the patient, the relationship, the trust, and get them to say yes to let's say, you know, 20, 30, 40,000. Case, then this is not for you. Now, I would say that the vast majority of us, I certainly am not in the category of being able to do that with an asymptomatic patient who walked in and said, yeah, I'm great.
I'm fine. I don't need anything. all right, so this is for everybody else. what you wanna do is you wanna make sure that you're not scaring away. The new patient by telling 'em everything that they need immediately when they told you already that they think everything is fine, that they don't have any symptoms.
and by the way, I mentioned Pete Dawson. I loved Pete. Uh, he wrote the forward of one of my books, and so I went through all of his courses and, and I learned everything. And clinically, it was amazing. . The problem is I came back into my office after two years of those courses and, and I was much better clinically, but when I tried to do what he said as far as case presentation went, and, you know, going through the whole thing with a brand new patient.
not too long into this, Isabel, my office manager takes me aside and she hands me this big legal pad with a bunch of names on it, and I said, what's that? She said, uh, do you recognize these names? I said, no. I said, who are these? . She said, exactly. She said, those are all the new patients who came in once you presented massive cases and they ran out the back door.
and she handed me this thing. I was like, whoa. I had no idea. So she didn't know how to fix it. I didn't know how to fix it, but I knew I had a problem. Mm-hmm. . And the problem was I was using great clinical skills, but when I came to the presentation, I was trying to do the, Dawson Pinky presentation and say, this is everything you need.
There was no trust, there was no relationship. . So over the years I did a lot of trial and error and I figured out a way to get by this, and I came up with three rules. So four your docs out there. If you're writing anything down at all, write down these three rules. This is for the asymptomatic brand new patient when you meet them.
Number one is don't take much of their time, so a treatment plan that requires them to come back 5, 6, 8, 10 times over the next several months. , it's already gonna be too much Friction don't take much of their money. So if the out-of-pocket is, you know, under a thousand dollars, that's fine. But if the out and if five, six, $700, that's all good.
But if the out-of-pockets gonna be 4, 5, 6, 8, 10,000 or $15,000, again, you're putting in stress in a relationship that doesn't need to be there yet, and you can retain that patient. If you don't do that at that point, I'm gonna tell you how to do that right now. Number three is don't hurt. Now you may be thinking, Tom, why would I wanna hurt a pa?
Well, you don't wanna hurt anybody, but you especially can't hurt a new patient. Cuz if you do, they're gone. So those are the three rules. what you do is you develop what I would call a phase one treatment plan, but you don't mention to the patient that it's a phase one treatment plan initially. this is where the rubber meets the road.
All you're doing is developing your phase one. If we were back in dental school, they wouldn't have you treatment plan an asymptomatic patient from beginning to end or any patient symptoms or otherwise. They wouldn't have you treatment plan the entire patient. You would do our first phase and then get that under control, whatever.
So kind of back to the roots a little bit. Now, what could be in that phase where phase one plan that won't take more than a few visits, won't take much of their money and won't hurt them, won't take much of their time. . All right. You could do whatever's needed, but you could do perio phase one, deep scaling and root planning.
Let's say you found some pit fisher and groove composites that were needed. You could do those. Let's say the patient requested whitening. Okay, that's fine as well. this is some examples, but it's low cost, low impact, nothing major. Not gonna scare 'em, not gonna take much of their time or money.
So that's a phase one. . Now, let's say you're looking in their mouth and you see that their posterior teeth have all these wide open margins on th 30 year old amalgams, and you pro probably have recurrent carries and frack, whatever. Mm-hmm. . How can you not tell them that? How can you just do a plan and tell them everything's great other than this?
Well, you can't, that wouldn't be ethical at all. So I had to bridge that gap and figure out a way to present something to them that would be easy, but at the same time would be ethical and, just be honest. So the way that I did that and the way that I recommend doing. Let's say you're just about done with your phase one plans.
you've actually presented it and she said, yeah, that's fine. Just a couple visits and not much money. So she is, that's fine. Then I would say, Mrs. Jones, I see that you have a number of old Mercury silver fillings in the back teeth and they look like they were done quite some time ago.
Is that right? And she would say, well, yeah, they were those redundant as a kid. Now, you know, she's thinking that you're gonna say that you need all this work in the back and, you know, crowns. And she's thinking, oh my God, not this. I hope I don't need all this work. don't even know this guy. These teeth feel fine.
Nobody ever told me I need anything back here. I let her think what she wants to think. But I finish up this sentence with, I made a note in my record, and by the way, I did make a note in my record. Mm-hmm. , so I case noted this. I said, I made a note in my record that in the not too distant future, I'd like to have you back for a more complete and thorough evaluation of those back teeth, just so that we don't miss anything important.
Would that be okay? And of course she's gonna say, yes, she's, you know that, that's all fine. She's not gonna say no to that. And so now she's happy. Cuz at this point all I've done is that little phase one plant and I. After we finish this first phase that we've just discussed, I'd like to have you back for more complete and thorough evaluation.
So now I've told her that this is a first phase, that I've not done a comprehensive exam, that I've not at all addressed all of the back things that we're looking at with all those big silver fillings, but that I do, and I might even mention to her, I do see some areas where, the filling itself isn't as tight against the tooth as it used to be, and it's letting things leak in there.
So that is something I'd like to take a look at, just so that we don't miss anything really important. Then I go through that first phase. She accepts it. You're gonna get really high acceptance of that. Again, to be clear, this is not a patient who came in with. a fracture, an abscess, um, or telling you that they need a massive amount of work, those patients know they need it.
I would move forward with whatever you think is appropriate at that time with that patient. Mm-hmm. , but because there's no relationship and there's no trust without relationship. and because the patient came in presenting saying, I have no problems. I think I just need a cleaning and a checkup. And that's your classic bread and butter patient who does need a bunch of work.
so we don't wanna scare 'em away. 95% of my new asymptomatic patients were really happy and they stayed with me and they came back and then we did the next phase evaluations. not only credible, because you're telling the truth, um, but it's something where when they come back, it's already a seed in their mind that they know that there's other stuff to do and they're happy that you didn't talk about it before.
you and I talked a little bit before we started that, um, really, I mean, the big 800 pound gorilla in the room is insurance. I mean, we're not gonna get into insurance today, maybe another time, but, but the big 800 pound gorilla is insurance. Why? Because. The vast majority of gps in the United States are mired in PPOs, and I was, I mean, I had that in my practice.
My dad had it in his. and it was what was killing me. and it took me about two years to develop a system, a strategy to get out of those PPOs. But I did it. So I went a hundred percent fee for service. And then when my dad was dying of cancer, he asked me to take over his practice and help my mom out financially, cuz all he had was debt.
He had nothing put away as in zero, no life insurance, nothing. Mm-hmm . It took my wife and me about two and a half years in that practice, the Worcester practice to get 13 out of his 15 plans gone and make it a very profitable practice as well. . And so I had mentioned, uh, earlier that, uh, what, what, what I have available for your listener is it's a, uh, free special report.
It's called a four Step System that dentists use to safely and predictably withdraw from PPOs and increase net profit. So if your folks would like that, they can get it right where you see over my shoulder. , www dot ppo fo and foe is F oe, so ppo fo.com. And that's, um, that's about it. I, I, I hope that covered it Well, not for
No. Yeah, that was fantastic, Tom. I appreciate it. And then we'll, play all that in the show notes below, but real quick, I wanna rewind a little bit to where we talk about, don't take too much of their. The three steps don't take too much of their money. So there's three
Tom: rules. Yeah, there's three rules.
Rule number one is don't take too much of their time. And what I mean by time is the number of visits. Imagine that you're the new patient, you don't have any symptoms. You presented to a doctor and you said, I'm just here for a checkup or a regular physical, whatever, they tell you you need to come back for a series of additional tests and treatments and and time outta work and whatever.
When you thought that there was nothing wrong and even. Maybe you just moved from another town and your previous dentist, who you were with for 20 years who you loved to death told you you were in good shape. again, to just to be clear, and I know I've said this a couple times, but it's important. This is not the patient who has a fractured tooth abscess emergency needs, uh, or massive reconstruction, and they know it and they present that to you that I need this all fixed.
This is the patient who thinks everything is just fine. And that's a lot of the patients we see today. So that was rule number one, is not a lot of time number. don't take much of their money, and I don't have an exact number, but I used to keep it well under a thousand dollars, so it might be three, four, $500 maximum.
And then they have some insurance that kicks in, you know, for part of it. Uh, but, but not much out of their pocket. Number three is don't hurt 'em. And, um, again, not to be facetious, we don't wanna hurt anybody, but, but especially with a brand new patient. I mean, if you inject them for the first time and you're doing a small filling or whatever it is you happen to be doing, or your, your perio phase.
and you hurt them, they're not coming back. I mean, there's a lot of dentists out there who'd be happy to, you know, treat them and do it, uh, in a very comfortable manner. So you just have to be extra, extra kind and careful to make sure that none of that happens and you'll retain a very high level of your, uh, very high percentage of your new patients.
It's wonderful, man. I
Michael: like the, how you broke that down with the phases too, how you kind of do it all in a slow type of growth, right? But you're building that, but you said you're building that relationship, that trust, but you. Establish the foundation with the relationship first. Right. And I feel like sometimes we just wanna hurry up and, And get
Tom: that in there. Well, the, the funny thing is when my office manager in the Framingham office, Isabel, when she handed me that, that, um, notepad, it was a legal pad. Mm-hmm. . And it had pages and scrolled of handwritten names. I was like, what is this? She said, exactly.
You don't know who these people are, do you? She said, I said, no. I said, Isabel, what's your point? Get, get to the point she, . Every one of those on those three or four pages is a new patient who you did the long form, you know, full exam and comprehensive treatment planning and so forth. All asymptomatic patients, all patients who came in saying, I, I think I'm fine.
I just need a cleaning and a checkup. And you told them they need 10 50 and 2030, what? Whatever you saw, and you were probably right, but you blew them all out the back door and, and again, at that point, We didn't have a solution, so I knew I had a problem, but I didn't have a solution and it took me a couple years to develop what I call the twenty twenty twenty new patient exam for maximum new patient retention, and that's what we just discussed.
Michael: Nice. Awesome. Tom, I appreciate your time and if anyone has further questions, you can definitely find 'em on the Dental Marketer Society Facebook group, or where can they reach out to you directly?
Tom: First of all, there's pfo.com, which has my information when they download that.
That'll have all my, my contact information in there, that special report. The other thing they could do is go to my Facebook group. The FA Facebook group is PPO O Exit. So it's a Facebook group and it's called PPO O Exit.
Michael: Nice. So guys, make sure you downloaded the special report. Go on the show notes below.
Everything's gonna be in the show notes below. Click on the links. And Tom, thank you for being with me on this Monday morning Marketing.
Tom: Michael, thank you so much. I appreciate the opportunity.