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The Forgotten Patients

In my experience, most practices have patients fall through the cracks, and an average 55% or less patient retention rate. To determine how well a practice is doing, dentists--and aspiring dentists--need only take a look at patient retention in order to get an accurate account. Are more patients leaving through the back door than coming in through the front?

When I ask dentists how they would like to improve their practices, a common response is, “I need more patients.” They are usually concerned about patient flow, but they skip key practice management protocols to keep patients coming back. These forgotten patients know you, they know your team, they know where you are located, and they consider you their dentist. It is not unusual to find another practice hidden in a single practice—for patients in need of a recall appointment or other treatment that has been diagnosed.

Every practice must know that retaining patients is vital to practice expansion and viability. Every team member must know that existing patients are the most important part of the practice and work on adding value to visits and building stronger relationships with these patients. My experience has been that the longer the patient stays away, the less likely it is that they will return to your practice. Many are already embarrassed about their mouths. The more time goes by, the more embarrassed they become about returning for care, so they go somewhere else.

There are three common ways patients can fall through the cracks:

  • Lack of a solid recall and reactivation system
    Most practices believe they have a recall system that is working. It is rare that I find this to be the case. You need to have a written plan that states who is responsible for what, and that the appointed employee has an exact schedule for reminder cards and emails. This is important so that staff members can follow the system exactly, month after month. Employees come and go; you need to have the system established so it can be easily duplicated by the next person.

    Even if you are taking advantage of services such as automatic appointment reminders, you should be aware of the timelines and templates you have established so you can follow up with patients. Practices that have these systems in place continue to grow despite the economy.
  • Staff is not familiar with dental software
    If your practice has dental software that assists in patient recall, every team member must be adequately trained on its use. The knowledge they gain will greatly benefit the practice. This is an area where you cannot afford to cut corners. Today’s practice management software allows you to do many things such as help with scheduling, send automated reminders, and notify your staff of missed appointments, to help prevent patients from falling through the cracks. You and the other members of the team need to know how to best take advantage of the resources you already have.
  • Little or no communication from the practice
    It is important that you communicate with current patients by using recall cards, recall emails, reactivation projects, birthday cards, holiday cards, etc. Some type of communication is better than none at all. The more you send out, the more appointments you will get.

Dental teams are constantly looking to fill their schedules and improve new patient numbers. These actions are important, but each of the above can help the practitioner to close the back door and retain more patients. When these patients stay with your practice and are happy, they will refer more people for dental care.

Most practices are not doing enough on a consistent basis to keep patients coming back. Often times, patients are inactivated too soon. This is a huge mistake. They still have teeth, and they still need a dentist. These patients are either going to see you or go somewhere else. Use automated “continuing care is due” reminders to keep the communications flowing to them. One of the most important things you can do to build a practice is to put your attention on your current patient base.


How Many Patients in Your Practice are Overdue?

The average practice has 750 to 1,000 patients overdue for recall appointments. This is largely due to weak or lacking recall and reactivation systems. Patients get left behind because no one goes back to check on them, and the practice stops sending cards and letters. Most practices are surprised to learn how many people need recare, especially when they have open time on their schedules.

Typically, practices will start thinking about reactivation projects when they are desperate for patients. To the contrary, reactivation attempts should be ongoing to achieve a consistent flow of patients rather than borne out of desperation.

Step 1: Generate and print a list of patients who have not been in for at least six months, and go back at least three to five years.

Step 2: Choose a recall card for mailing to these patients. You may also consider combining this with emails to the patients. The recall cards and emails should look different from others you have sent in the past.

Step 3: Customize your recall email message. Surveys suggest the following message gets the best response. Dear [insert patient name], we miss seeing you in our office. As you know, when dental decay, gingivitis, periodontal disease, or other complications are discovered in early stages, treatment is not complicated and costs are less. Please phone the office at [insert your phone number including area code] for a convenient appointment.

Step 4: Send the same card and/ or email message to the same group of patients two to three months in a row.

Work to implement a patient retention system to help close the back door and keep more patients. Focusing on patient retention will not only fill your schedule, it will provide a steady flow of patients, and you’ll have a much healthier practice.


*Internationally recognized lecturer, author, and practice management consultant. Ms. Pardue has assisted hundreds of dentists with practice expansion and staff development over the past 25 years.

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