Is your Practice Half Empty Or Half Full?

So, how’s the traditional new patient ‘autumn rush’ going where you are? 

Back at Breathe HQ, the Team are receiving reports from all over the UK and we are seeing little evidence that the rush is happening this year…

However, there are many exceptions; practices whose third quarter in 2011 has been their best ever, practices who have plenty of new and returning patients and practices who are recruiting new fee earners to cope with the demand.

These days, I visit a lot of practices that have plenty of spare capacity. However, there’s a big difference between a practice that is half empty and one that is half full. The first is shrinking and the second is growing.

We are seeing two very different practice situations and (not surprisingly) two very different sets of practice behaviours.

Let me describe the behaviours of some of the practice owners and their teams whose practices are shrinking.


  • Are scared, nervous, anxious, not sleeping well. Some banks are revisiting their lending conditions (owners are living in dread that their existing loan might be called in).
  • These practice owners are hoping, with all their fingers crossed, that the politicians will sort it out, that the media will write about something other than the economy sometime soon and that growth and confidence will return to the UK market place, preferably before Christmas.
  • In these practices, fear stalks the corridors – you can see it in their faces – and one thing I know is that feeling anxious is no way to run a successful business.
  • Stuck in crisis mentality, there is a tendency to react by reducing their costs. Practice owners have become too reliant on pulling the cost saving lever. They pour over their bank statements looking for standing orders to cancel (including ours!) and interrogate their reps for cheaper materials, whilst holding their long suffering labs to ransom by paying late and asking for bigger discounts.
  • They have stopped communicating with their teams (except to complain about them).
  • They have absolutely no idea how to grow their practice in these market conditions… Neither are they willing to invest in doing this.


  • Are unlikely to offer cosmetic dentistry, preferring to take the clinical high ground by saying it’s not necessary for their patients or that they don’t really believe in it.
  • They are happy to refer their Orthodontics and Implants out to others even as their days become increasingly gappy.
  • Their Associates and Hygienists have started to reduce their days and are looking for work in other private practices (often in vain) and end up saying yes to NHS work.
  • Some of these practices still close their doors at lunchtimes and all day Fridays, seemingly content to let their phones go unanswered or at best answered by a machine!
  • Their patients can’t get an appointment before 9am or after 5pm and definitely not on a Saturday morning.
  • The team have poor communication skills and have never been taught how to answer the phone or how to close a sale.
  • The Team believe and hope that the patients will never leave because they have such a good relationship with them.

PRACTICE FACILITY The clues are all around from the moment you arrive.

  • There is little to tell you about the practice from outside and the practice is often hard to find. The signage is terrible and there are no clues as to what the practice does or whom it serves.
  • The decor is tired. The run down waiting area has uncomfortable seating, dreary pictures and lots of notices, Blu Tacked or cellotaped to the practice walls, telling patients how to behave.
  • There’s a lingering antiseptic smell. 
  • The Receptionist is hidden away behind a glass screen or an imposing counter. 
  • There are scant clues as to what the practice offers; except perhaps some leaflets or posters for branded treatments such as Invisalign or Zoom Whitening.
  • The Practice is in need of modernisation; it desperately needs redecorating, re-equipping and rebranding. The surgeries are old, the equipment is vintage and there are no patient consultation areas other than the dreaded dental chair.
  • The Staff room has become the dumping ground (and sometimes serves as an office too).
  • The loos are plain, cold and empty. 

PRACTICE SALES AND MARKETING  These practices haven’t got past first base in the marketing stakes.

  • They have no kerb appeal (I’m not just talking about an uninviting exterior; businesses are now being judged on their online kerb appeal too).
  • They have no ‘patient get patient’ programme and their website produces very few new patients.
  • They don’t know how many leads they are getting because they haven’t asked their receptionists to record them.
  • All their new patients come from word of mouth referrals yet they do nothing to encourage more of them!
  • They have no Treatment Menus and not surprisingly, their treatment plans are forever small.


  • Have been very loyal and many have stuck with the practices for a long time. However, at around £80 a go, they are beginning to ask if they are getting enough value from their 6 monthly check up and scale and polish appointments.
  • So, they postpone their visits and hang onto the thought that they can pick up the relationship again once the economy brightens up. In the meantime they keep the phone number somewhere safe, in case they get toothache.

I trust you will have realised by now that I have exaggerated (a little) to make the point.

Just because practices like the ones I have described have worked in the past, doesn’t mean that they will ever work again in the future. In my view, they will slowly and inexorably decline.  Life has simply moved on.

However, if you recognise any of the above in your own practice, it really is time to stop hiding and hoping it will get better.








HOW TO SHRINK-PROOF YOUR PRACTICE Here are some essential tips to help turn your practice around.

Steps to take NOW:

  1. Make sure your facility is clean and fresh.
  2. Decorate and de-clutter. Get rid of the Blue Tack, the dead light bulbs, the cardboard boxes etc!
  3. Extend your opening hours
  4. Answer the phone at lunchtime
  5. Clean up your database, create an active patient list, and start reactivating your dormant patients
  6. Have some autumn offers
  7. Sort out your practice kerb appeal
  8. Put a banner outside the practice saying that you welcome new patients


  1. Start behaving confidently and inspire your team to do the same
  2. Get a business plan that includes an effective marketing plan.
  3. Create an effective sales process

Go ahead, do something TODAY to improve you business and turn it around.


Simon Hocken Director of Coaching, Breathe Business


If you would like your practice analysed by Simon Hocken, or you’re looking for additional information and advicecontact the Breathe team on 0845 299 7209 or

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