Many long-established dental practices are not really interested in growth. They have to replace the patients who are leaving (somewhere between 10% and 20% every year of their active patient numbers), but other than this, they seem happy and content (or is it resigned?) to keep things same old same old…
Some new or more ambitious practice owners want to grow their practices. There are two obvious ways of measuring practice growth:
- Financially: by measuring gross and/or by measuring profits. And
- By measuring “Active Patient Numbers”.
Both are reliable yardsticks and predictors of growth, but it goes without saying that without enough active patients, it’s much harder to have a viable practice. Practices are usually good at measuring new patient numbers (although hopeless at measuring the source of these new patients), but they rarely take into account the leavers. I’m afraid this is simply vanity.
So, consider a medium-sized, private dental practice with 2,000 active patients. That’s enough work for two full time dentists (or the equivalent) and 6 days of hygienist treatments. In a slow moving environment (small town or rural area with only a few dental practices), you might expect the attrition rate of this practice to be in the order of 10% (200) patients per year. Therefore, they will need 17 new patients a month to remain in steady state ~ and that is exactly what most of these practices are doing. A practice in a busy city with people living more transient lives and lots of competition from local dental practices might have an attrition rate closer to 20%, which means that they need 33 new patients a month (400 pa) just to stand still ~ and that is what most of these practices are doing!
If you think my attrition numbers are high, I really recommend you measure your own. Here’s how we do it at Now~Breathe:
- Measure how many patients your practice has seen in the last 4 years. Let’s say it is 2,850 patients.
- Measure how many patients your practice has seem in the last 2 years. Let’s say it is 2,200 patients.
- Subtract 2,200 from 2,850 = 650
- That’s 325 patients per year in year 3 and year 4.
- Calculate what percentage 325 patients is of 2,200 patients, 325/2200 X 100 = 15%
- That’s your attrition rate. 15%.
Let’s imagine our medium sized practice with 2,000 active patients, has an attrition rate of 15%/year and is getting a healthy 40 new patients per month as a result of their effective word of mouth referrals and their sophisticated marketing and sales processes. Their monthly patient attrition rate is therefore 25 patients per month and, therefore, their net gain in active patient numbers is just 15 patients per month.
At this rate, it will take them around 5.5 years to grow enough active patients to hire another full time dentist and another part time hygienist (3 days/week). Many many practices think that this is a viable growth strategy, but frankly, it’s like watching paint dry. Way too slow, too slow!!!
So here’s another, better, tried and tested strategic approach:
Providing your practice active general patient numbers are over 1,500 (and preferably nearer to 2,000 or more), simply accept that this is the size of your active general patient base. Just make sure that you replace the patients who are leaving.
Now, consider the services beyond general dentistry, that your practice doesn’t currently offer at present, or only offers in tiny amounts per year and the services that you currently refer to local “specialists”. These are inevitably high-value treatments (as opposed to low value check-ups and fillings) such as:
- All On Four
- Kids Orthodontics
- Adult Orthodontics
- Facial Aesthetics and Medical Skin Treatments
- Advanced Restorative Dentistry
- Cosmetic Dentistry
You will (of course) find patients who want these services from your own active patient base as well as from much more focused and specific marketing campaigns. (And also possibly from colleague referrals).
The numbers are simply compelling:
2,000 active general patients will keep 2 dentists busy full time and they will gross circa £500k between them. These 2,000 patients will require 6 days of hygiene which will gross circa £225k making for a total £725k/year gross practice.
This is an average, in every way, 3-surgery, UK Private Practice. There are many of them out there! (Ask the Practice Sales Agents!)
However, if you were now to add a selection of these high value services, say:
- 100 implants/year = £250k/year
- 50 facial aesthetic patients @ average annual spend of £900 = £45k/year
- 3 adult orthodontic starts/month average patient value £3k/month = £108k/year
- 1 day of endodontic treatments/week + £6k/month = £72k/year
That’s an additional £475k gross fees/year, making a total practice gross in this case of £1.2 million/year.
This is likely to require 3 extra surgery days/week, which it may even be possible to accommodate within the original 3 surgery layout, by extending the opening hours. And, the marketing can be much more targeted at these high value services (new general patients will come anyway) and, therefore, much more effective at producing patients.
Of course, it’s not all up-side! If you want to run with this strategy, you will have to find:
- The time, the knowledge and suppliers to enable you to introduce these services into your practice
- Surgery space
- How to effectively market these services
- An effective and rehearsed and measurable in-house sales process
- Suitable additional clinicians (there is a surplus of these at present!)
- More staffing/longer opening hours
- Some extra kit such as: CT Scanner, Intra-oral Scanner, Digital Dentistry Set-Up, Orthodontic Kit, Cerec Machine etc etc
- An open mind and tons of enthusiasm and support from your general associates
If you do run with this strategy (and many of our existing clients are doing this, from squat practices to long-established practices), you run the risk of substantially increasing: the turnover, the profitability and the sale value of your practice.
What’s not to like about that?!
If you would like to discuss how this might work in your practice, contact me for a chat: