Wednesday, May 11, 2011


Hey all,

I started reading a new book: The Girl with the Dragon Tattoo. I have heard everyone who reads this series loves it. The book is 600 pages, so when I am done with it IN NOVEMBER, I will let you know.

I want to talk to you about our recall system. Well, a better way to say this is I want to talk to you about our lack of a recall system.

I used to have 3 front desk people. I have let someone go and someone left after having a baby, so now I have one strong one and a person that we train and she leaves then another one we train and she leaves. (We just hired a third try and we have a good feeling about this one.) One thing that has been left in shambles with all the personnel transitions is our recall system. First and foremost, our recall sucks. It used to be postcards that read, "Time for your cleaning."

Now, no one is supposed to leave without a 6 month recall appointment. If they do, we are supposed to call them. This dialogue is suppose to go something like this:

"Mr. Jones how did your cleaning go today? Oh great, I am glad you liked Kelly. Your 6 month cleaning appointment is going to land us in November. Was this a good day and time? Good, then I will put you down on Wednesday, November 12 at 3pm. We'll send a reminder card and I will see you in November."

Sometimes, Mr. Jones might say, "I don't have my schedule. I will call you when I get to work." This should no problem.

We are supposed to say something like, "No sweat, I will talk to you later then. Oh, listen, if I don't hear from you by Friday, I will give you a call. Is work or your cell the best number to call?" This way, the ball is never left in their court.

Rarely, someone slips through the cracks. And that is still okay. We have the list of patients that are overdue for their cleanings; this is where we drop the ball.

We have a one month list, a two month list, three... you get what I mean. We haven't gotten to the one month list, so it continues to grow. In the past, the front desk has been responsible for calling people on the list. But now that our hygiene schedule looks like swiss cheese, we have started making this a practice-wide duty. All hands on deck.

This has been a real struggle. I walk around seeing people standing around, talking and I see a list that is 4000 people strong. Then other times, everyone is on it and two people call the same person. So, it is a very complicated. When you talk to someone, when you leave a message, when you get a bad number, you are always supposed to write a note in their chart. Which means that before you call the number on the list, you have to look up their chart to see the notes made from before; it becomes very time consuming.

Someone might sit down to make some calls and get about 10 calls an hour. If the list has 100 people on it, imagine how long that would take. You get to 50 people ,and next thing you know, the list has 150 people on it. So you call the one month people, or half of them, and you just stick to the one month people. After three months, the one month person is now three months, and next thing you know they are slipping through the cracks.

I don't know of a solution. I am a freaking dentist, for crying out loud - I don't know how to run a recall system. And really, part of what we do is try to eliminate people off the list. If they are not coming back, at least they are off the list. How many times do you call them? Are we stalking them? Emails, texts, calls.

Eventually we send them a letter saying that we like having them as a patient and we want them to come back ,but because we haven't heard from them we are going to inactivate their chart. This means we will not be calling them anymore, but it doesn't mean they can't come back here. "When you are ready, just call." Then, all of a freaking sudden, we get a call from them.

I don't know. Am I the only one that has lost all control? I am thinking about bringing back the postcards. What do you think?

Have a great Wednesday


Patient Activator said...

Many practices are automating their patient recall systems with great success. A recent Dentaltown reader poll named electronic reminder systems one of Dentistry's 50 Biggest Game Changers. These systems automatically send patients personalized text and e-mail recare reminders and appointment confirmations. Some offer a “live” call option that enables the office to record personalized phone messages. Most systems work with the office's existing practice management software. The systems are great for freeing up the front-office staff for other duties and eliminating the hassles that turnover causes.

Cynthia Becker DDS said...

About 6 years ago now, we computerized our clinical systems. Although it was a real hassle at first, the ability to get AUTOMATICALLY UPDATED data from the computer rocks. If you have 4 people making phone calls and they update each record as they go along, the person calling from a different terminal will immediately see the changes and this cuts down on multiple calls and duplicated effort. However, we still send postcards. Despite advice to the contrary from practice managers who say we need to "get serious" with our message on the serious topic of dental health care, we pick the funniest postcard (like Baby Blues or Kathy or some such cartoon) to get their attention. Then out go all the cards. We send to 1 mo, 2 mo, 3 mo and extremely delinquent patients all with a different message generated by the computer for the time the patient is late for preventive. 3 calls is all we do, then all is by mail, we count text and email as a "call". Having had a manual system for 22 of 28 years, I prefer the computer. The other depends too much on the person who runs it. Other computer systems may be more complicated, but the computer is made for running a recall system. you may wish to consider some sort of automated system. I wish you luck on the admin hire...I always say it is like recruiting someone to sit in a foxhole and get fired upon.....Third time was a charm for us...I now have an ace in that area. She even gets along with everyone! (She was admin #3, but the one in charge of "recall" or what we now call "prevention appointments" Cynthia Becker DDS MAGD

Stacey Reiss - Demandforce said...

I have a solution for you, a software program called Demandforce. Demandforce is a web-based software that integrates directly with your dental software to automate your patient communications through email and text message. Demandforce streamlines your recall efforts by automatically reaching out to your patients via email (and text) when they are overdue and allows them to easily request an appointment through this email 24 hours a day/7 days a week. Demandforce also automates your confirmations and reminders as well as provides a suite of other services to help retain your patients and grow your practice. Practices on average see their phone call volume drop by 50% and their no-show rate by 20%. Check out our website at

Dmcphee said...

John, your problem is no one owns this job. I know your front desk has been a revolving door, and as soon as you get one trained she leaves (for whatever reason) but this has to belong to someone, not “anyone who gets around to it.” Even if you move to an automated system, someone has to be in charge of it.

If possible, maybe your lead assistant could be in charge of the calls. She can make the calls on a Saturday or another day when you are not there. What if you offered 1 dollar to every appointment that holds. Seriously, let that sink in a minute. Would you pay a buck to get a live person in your chair for a cleaning that might lead to a crown? Of course you would! If those girls are on hourly money, it’s a good way to make an extra 10, 20 or 50 bucks a week! 50 bucks means taking her kids out for pizza or buying something extra.
I know you have four kids and 50 bucks out means…………wait a minute here! It means you have 50 new appointments! Win-win for everyone!! Can you imagine 500 of your list of 4000 booking appointments? That’s more than 50,000 worth of production just for hygiene. How many will spin off into your chair?

If it is impossible to get one person to handle the job, have a team goal.
Dr. John: If we hit $50,000 of additional hygiene production this quarter I will take you (fill in the blank) I’m sure with $50,000 you will think of somewhere nice. Whether it’s out to eat or a cruise, if they have something to work for, (above and beyond their hourly wage) they will do it.

I hear the same thing from dentists every day!

When interviewing, ask about phone skills and willingness to make phone calls. Most people do not like calling people and asking them to do something unpleasant (unpleasant meaning “go to the dentist”) and they won’t do it. They may tell you that they are, but what do you know, as long as they can hear your drill, they know their time is their own.

When you hire someone new, look for some sales experience along with office experience. It’s worth a buck or two more an hour to get someone who thinks it’s a challenge to fill the book, not be afraid to pick up the phone. It’s nice to have happy patients, but at the end of the day, you are running a business, and businesses make money! 4000 patients that need appointments is like $400,000 of production in your parking lot that won’t come in.

Another little trick: Make the recall appointment BEFORE they go to the back office.
Office manager: Mary, it will be just a few minutes before they are ready for you, let’s get your next appointment on the books now before the phone starts to ring.
OR have your hygienist book the appointment from her computer in her room before she dismisses the patient.

Hope this helps…….

Deborah McPhee
Dental Industry, Chicago

Anonymous said...

Make sure your front desk person never leaves.... mine has been with me 18 years. Patients don't even think of leaving without setting up an apt to see her... not me, but her... she makes more money now than I did after 5 years of practice... some months more than my associate

Anonymous said...

In my office it is understood that the recall system is the practice's central line. I have a dedicated team member who is managing all aspects of it daily. The immediate, short, medium term and long range elements are her domain. The rest of the crew is conditioned to help out just as the hygiene coordinator is cross trained to fulfill front desk roles and she shares in our Saturday rotation. The goal is to meet or beat 93% schedule utilization monthly. Everyone knows how I feel about having open time in a producer's schedule. The net effect is our patient base is equally on board and tend's to schedule while in office.
We utilize a combo of cards, Smile Reminders email and text msgs. We certainly have our moments and flaws, but YTD we are at about 94% hyg utilization with 5 FT RDH's. I also employ 2 FT assoc DDS who do perform occasional hygiene svcs. My partner and I rarely see hyg in our schedule. Our total practice vitals are up 10+% from a year ago.
I could ramble on, but I hope that at least gives a flavor of my situation Regards, Tom Reed in Denver, CO Sent from my Verizon Wireless BlackBerry


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