The New Patient Mistake 90% of Practices Make

Before you spend another dollar on marketing, look at this first: your phones. Most practices assume their staff has it handled because calls are coming in and the team feels busy, but missed calls and poor phone systems could be costing you more new patients than you realize.

In this episode, the DPH coaches explain how to audit your phone systems, reduce missed calls, and get more new patients on the schedule. You'll get ideas for simple workflows and automation tools that keep calls from slipping through the cracks.

Topics discussed:

• The most overlooked KPI in most practices
• How to use phone trees, auto-attendant, and automatic texts
• Phone training and the nine most common call scenarios
• Why you should prioritize new patients and emergencies
• KPI benchmarks and what every practice should track
• How to create a culture where phones are prioritized
• Why practices always need new patients

This episode was produced by Podcast Boutique https://www.podcastboutique.com

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Transcript

The Hidden Cost Of Missed Calls

Paul Etchison 1:55

You probably think your phones are being answered just fine. I mean, they're ringing, the team is busy, and the patients are coming in. So it feels like that part of the practice is handled. But here's the uncomfortable truth. If you haven't actually looked at your missed call rate, listened to real calls, or tracked what happens in new patient inquiries, chances are you're almost certainly wrong. In fact, I bet right now you're losing more new patients on the phone than you ever lose because of marketing, fees, or competition in your area. And the worst part, you don't even feel it happening. Today you're going to learn why new patient flow lives or dies at the front desk, what practices are doing wrong without even realizing it, and how simple changes to phone systems, training, and culture can dramatically impact revenue, schedule stability, and practice growth. So if you want more new patients without spending more on marketing, this episode is going to matter to you. Now you are listening to the Dental Practice Heroes podcast. I'm your host, Dr. Paul Etchison, author of two books on dental practice management, dental coach, and owner of a large multi-doctor practice in the south suburbs of Chicago. And this show is for dentists who want more than just a busy schedule. And today I am joined by my DPH coaches, Dr. Henry Ernst, the owner of an 18 operatory practice in the Carolinas, just working two clinical days a week, and Dr. Steven Markowitz, who is the owner of six practices on the East Coast, seeing patients just one day a week. We are talking about the systems that create profit without chaos, time off without guilt, and practices that don't fall apart when you as the owner step away. No hype, no hustle culture, just real-world conversations about how great practices actually work. All right, let's get into it. Hey, welcome back to the podcast. Thank you so much for listening. I'm joined with my coaches here today. And what we're gonna take apart is something that is often missed in most nearly all offices. And I would tell you, if you think this is good at your office, it's not. It's just almost, I would say like 90% of the time, it's probably not. So what we're gonna talk about today is, you know, we love new patients. New patients are the best. We love new patients. How do we get more of them? We know they're the best thing for keeping our schedules busy at most offices, reflection of every metric, you know, collections, revenue, all that stuff, can usually follow this metric of new patients. But yet we do nothing to optimize the new patient flow. And we completely just we turn on our phones and we let them go. I'm gonna go to you first, Steve. What are your thoughts on optimizing your phone system so that you can get more new patients or just be more effective up there? Okay.

Culture And Training For Phones

SPEAKER_01 4:32

First off, every single person in my organization gets phone training. And I start that training by saying, like, I know this is gonna sound obvious, but this piece of equipment may be in the top three most important pieces of technology that we have in our entire office. That needs to be the culture that's set. And everyone needs to be trained because we are in a service business. So we start by having the business team understand that their job is customer service. And part of that starts with availability. So we cannot miss phone calls. We measure our the number of times we have missed phone calls. Our expectation is that 85% of our phone calls are answered.

Paul Etchison 5:15

It's interesting. I was just in India with relevance online marketing, and we were looking at the 100 and something clients that there are, and we are looking at a total scoreboard of the phone answer rates because this is something that they track within their software, within the marketing stuff. And my office was like at the top of it with like 75%. And I was just blown away. And they're like, no, that's good. I'm like, that doesn't feel good at all. Most offices are about 50, 60%. So yeah, continue. I just wanted to add that little stat.

SPEAKER_01 5:43

I think that uh data is so important. So most people are saying they want more new patients, but they're only picking up the phone 50 to 60% of the time. So anytime I call a business and they don't answer and I don't know them very well, the last thing I'm gonna do is call them back. I'm going right down to the next person I found on Google. So when you're working with your marketing company, if your leads are high and your conversion, meaning the number of people that are looking you up online and calling your office, and your new patients isn't aligning with the number of conversions you're having, and you should get that information from your marketing company. It's the operational support is what's causing your lack of new patients, not your marketing company.

Paul Etchison 6:25

Yeah. And I think it's one of those things that we need to look at these numbers. And it's a metric we never see because it doesn't show up on a dashboard or anything like that. I mean, maybe it does, but we've got to log into a different place for it. It's not with our other practice analytics. But it's like your marketing company should be able to tell you how many leads, how many views and impressions ads are getting, how many people are coming to your site, how many people from that site are converting. Where is the breakdown in the conversion? So, what are your thoughts on this, Henry? So Steve's doing phone training. I'm also doing phone training, which is the actual phone training that we provide for dental practice heroes clients. I'm doing phone training. That's my phone training with my team. What are you doing at your office, Henry?

Phone Trees, Auto Attendants, Text Back

SPEAKER_00 7:02

Every successful practice owner does this. We do phone training also. It's important. I think you said it well in the beginning, Paul. If you're one of these people that think, oh yeah, my practice is good, man. It's all fine. Trust me, it's not. And once you start investigating this, have a bourbon next to you or have some cookies or whatever makes you happy because it's going to be stressful. Number one is if you don't know what your missed call rate is, it's a lot lower than you think it is. I promise you, right? That's the gateway to your practice, kind of like Steve was mentioning. It's a lot higher than you think it is, you mean? Yeah, there's you're missing a lot more calls than you think, right? There's so many opportunities out there. And just like Steve said, if I have no relationship to you, I'm this is 2025. I'm going to the next one, going real quickly. But the second thing that I would say in this whole scheme is yes, let's make sure we're answering the calls. Let's be prepared to change our strategy. So when our practice was growing, all of a sudden we had a huge dip in missed call. So we had to change our strategy. We created a phone tree. So this way we could like separate the calls because yes, the new patient calls are a lot more important. Also, look at your playbook. Like, look at your capacity. If you're answering the phones and they're actually answering the phones and they're actually saying what they're supposed to say, if there's no capacity, in other words, the next hygiene visit is six months from now, you're screwed, also. So you're gonna have to fix that too. So that don't forget that part of it, right? So the number one, I love this term from sports. The number one ability is availability, right? If you're a great athlete, but you're always hurt, you're worthless, right? You gotta be available. So make sure you're answering them. Don't be afraid to check those things and stay on top of them. That's one of the metrics that we still measure to this day is missed call rate. So we stay on top of it. The team knows that we're on top of it. But then also be prepared to change your game, whether it's the capacity, whether it's adding a different way that you're answering the phones to make it work.

The Nine Call Types Framework

Paul Etchison 8:50

I would love to circle back onto the phone tree thing because this is another thing that we've done. There's something called auto attendant, and I won't share what void provider I'm using. I think you need to have the voice over internet proxy to do things like this. I think you do it with older systems, but it's it's kind of seems kind of clunky. But auto attendance where it's like picks up the phone automatically. So you don't miss the call, it immediately throws them on hold. And what you can do there is as your first line, is let the patient know something nice about your office, but then also tell them that they can schedule online. So that'll save you some phone calls. So for the people that want to not talk to people, which is becoming more and more each day, that'll save some phone calls. But what my system will do is that if we miss a call, it immediately generates a text to that person. We are so sorry that we couldn't make it to the phone. We are on the phone with other patients. What can we help you with? And I would say that that saves a lot of patients. And I know there's other things too. There's like AI receptionists and things like that. And I know on our mastermind call recently, just last Friday, we had somebody mentioning that they were sending all billing questions to a voicemail, but then saying on that voicemail, please tell us your issue, your name, and we're gonna look up all this information and we're gonna call you back. And preferably at a time that's not around like lunchtime when we have high call volume. So all these things are important.

SPEAKER_01 11:27

So to get back to training quickly, we train on nine types of phone calls. And I think this is important. And I would I would recommend every practice owner go through how they exactly want their team to answer the phones when someone has is a new patient, a price shopper, asking if they take their insurance, an emergency patient, how to schedule an appointment, billing questions, questions they don't know the answer to, how to set expectations and upset patients. Those are the nine scenarios that when we do our training, we break it down and really clearly give it's not scripting because I I don't want to tell people exactly what to say, but I want to give them tools on how to manage those nine areas. And if they can do those nine, they feel good in those nine areas and feel comfortable and have some themes of how to and end of those conversations. 90 plus percent of those phone calls will go break.

Preventing Confusion And Documenting

Paul Etchison 12:19

Yeah. And I'm gonna let the listeners know. Did you just spit that off of your memory?

SPEAKER_01 12:24

No. Oh, yeah. I was not on the screen. I was reading it. I knew we were talking about phones.

SPEAKER_00 12:27

You didn't look like you pulled anything up. I was feeling very inferior. I was feeling very inferior for a second there, Steve.

Paul Etchison 12:33

I know. I wasn't gonna be like, I bet you can't name all nine, bro, but he did it. He had beautiful at that time. But it's so true. The thing is, is like it's not that scientific. It's like they just need a good response to a few things. I remember one time, you know, this is a very random thing, is a phone call that I heard. And it's actually in the training. I think it's in the training. Someone was asking, my other dentist told me I had to get this tooth, a root canal. I don't want the root canal, I just want the tooth pulled. And the French desk person was like, No, no, no, that's not up to you. That's up to the dentist. The dentist gets to decide what you do with your tooth. And she's just like, What can what are you talking about? And she's like, Yeah, no, you need to come in. The doctor's gonna decide what you're gonna do. And she's like, I don't want to have the root canal. But it's like, come on, man. No one, you would never know if you didn't listen to it.

KPIs That Actually Matter

SPEAKER_00 13:14

Yeah, one thing else that comes into mind too is uh whenever your practice is adding something new, a specialty procedure, or sleep apnea, for example, years ago when we did it, you got to make sure that you got some simple, simple answers, right? Or else you're gonna hear this person said this and this person said that. Now you're getting the hearsay kind of stuff here. So just another thing that just came to my mind as you were talking is that's another one that comes up there, like specialty confusion, I call it, where they've said this. What's the next step? And if you don't know the answer, a lot of times, hey, I'm fine to have a conversation with somebody. Put them on my schedule, right? You made another great point too, Paul, before is what are the most valuable patients? Everybody's valuable, obviously, but new patients and emergencies. I want everything pushed out of the way to get those people to me, right? So the phone trees work great where you can, like you were saying before, like if you got in a billing question, you go here. If you're an existing patient, go here. And also, like we came up with this years ago. If you're a new patient or you have an emergency, it's fifty dollars. Fifty dollars. That's it. Do I need a pan rex? Do I need whatever I need? I don't care. I want you to come now. So something you can come up with in your own office to just get rid of that hesitation and just don't have to get off the phone, put it on hold. No, you're coming now. It's$50. Would you like to come now?

Paul Etchison 14:31

Yeah, absolutely. And you know, the other thing too that popped in when you just said that is communication notes. This is probably an issue that we all experience in our larger practices. I don't know if this was such an issue in my practice when we were smaller. But and it's probably not as big of an issue. But it would drives my office bananas when somebody calls and says, Yeah, somebody I talked to told me this. And they go up in the chart and look at the communication notes. Nothing. No entry. Oh, I'm sorry, I don't know who you talked to. Do you know who you talked to? No, I don't remember who I talked to. And then it just makes us look stupid. It makes us look unorganized. And it's embarrassing, but at the same time, it just comes down to basic just documenting what you're doing up there. So there's a lot of work that can be done in the front desk. And I think it's hard because there's not a ton of just KPIs to look at. Like I'd love to like talk about that. Like, what are some KPIs that we should be tracking for a front desk? We already mentioned missed call rate. I know a lot of people are not doing that. I love the schedule utilization. I think that is a metric of showing how well they're filling things. But then at the same time, I would tell you one of the biggest issues that I hear with people's complaints of the front desk is they don't fill the schedule enough. It's always the lowest priority. So, what are some KPIs? I mean, Steve, you're sitting back looking at six practices. Like, what are you chucking? Or what are you chucking just to see this uh?

New Patients As A Growth Engine

SPEAKER_01 15:45

I think you nail it. We don't need to make it more complex than are we picking up the phone and are we filling the schedule? What I loved about what Henry said before was he makes it known how important new patients are to the health of the business and that we get to help people who need us most. A lot of times when I'm talking to clients and they're talking about we need more new patients, and I'm like, have you told the team? They look at me like I've just said something crazy at them. I'm like, no, no, no. They're answering the phone. They're the one that needs to actually know that new patients are important to the health of how we're gonna take care of our patients, how we're gonna take care of people. Your job and your own growth and your career is important. It lays on whether or not we can get more new patients. So, what I loved what Henry said was like, yes, this needs to be the culture. We are the practice where new patients should go to. And we want to encourage people who need us most to schedule right away. And the same thing happens when schedule utilization rates. If there's an opening, it shouldn't be on the doctor to come up and say, Hey, I have an opening tomorrow. It should be like all hands on deck. Hey guys, we have an opening tomorrow. Have you called this a doot, doot, doot, doot? Like everyone should be working. It should be the person who's responsible for that schedule should know it. They should be leaning on their colleagues and their team to help fill it because that needs to be priority. In our office, it is person in front of you, person on the phone, schedule. One, that's the priorities. One, two, three, and then you can get to all the other stuff that I know is important, but it's not as important as the person in front of you. It's not as important as the person on the phone, and it's not important as important as the schedule beautiful.

Paul Etchison 17:26

Yeah, I mean, it's definitely a culture thing, but like most docs feel like they're just walking up there and just pissing everybody off, you know, because it's inconsistent. It's like the only time that there's ever focus on filling the schedule is when finally it's one o'clock and my one o'clock is not here. And then it's like, oh, now I'm gonna go up there and I'm gonna find out what happened with this opening. It needs to be a constant thing, it can't be something that you talk about every now and then. It's got to be culture.

SPEAKER_01 17:51

Sure.

Capacity, Blocks, And Priorities

Paul Etchison 17:51

One thing that I thought about was, and I have no evidence to back this up. And I'd love to hear what you guys think of this, but I think there is a certain percentage of our patients that think we're just doing so damn well that we're not even seeing new patients, that we don't need new patients, that we don't care about seeing new patients. And I've always felt it helpful when I was when I was seeing a lot of new patients to let them know hey, and if you know anybody else that needs a good dentist, we would love to see them. Send them our way. And I know this because, and it's you typically like somebody in like their 60s or 70s, they're just like, wait, you're still accepting new patients? What? Oh my gosh, you guys are so busy here. So I don't know if that does anything. I think that'd be very hard to measure, but every little thing helps.

SPEAKER_01 18:30

Steven. I don't not only do our patients uh think that we're not accepting new patients, uh so does our team. Because with our practices that are super busy, and both you guys know, like even when you have some capacity issues, it is so wildly important that our new patients, we still continue to see a certain number of new patients for our schedules to maintain being as busy as we want them to. At least once a year, I am showing and comparing how much a new patient treatment plan is to a existing patient. And that it is almost three times as much treatment planned in a new patient than it is in a existing patient. So those new patients need us three times more than our existing patients. And that needs to be on repeat so that the team just knows, like, yeah, when when there's opportunities to see more people or see new a new patient, we're gonna take advantage of that because it's the best thing for them.

Paul Etchison 19:21

You know, I'm curious, Steve. I know me and Henry, I think we're very similar on the numbers of new patients we think an associate needs to see. I think I'm 35. What are you, Henry? 30. 30. So 30 per true doctor. 30 to 40. Have you found that in your practices, Steve, that the ability of certain practices to attract the right amount of new patients can really affect the capacity and amount of doctors you're able to have at that practice. Because I mean you got your flagship practice with you know 100%.

Referrals, Reviews, And Momentum

SPEAKER_01 19:47

I think it is very dependent on service mix and number of active patients and whether you're there are some doctors that love doing only quadrant dentistry, someone like doing one or two. So it's very doctor-dependent of how many new patients they need, but we are a minimum of 25 to really see consistent treatment plan that they don't have to be concerned about their schedule.

Paul Etchison 20:09

Yeah. Henry, do you think there's ever a position, and I'm curious with your practice, and this would be a good question for you, Steve, as well as for your flagship. Is there ever a, you know, portion in the maturation of a practice where it's like just don't need new patients anymore?

Simple Rules: Answer, Be Kind, Measure

SPEAKER_00 20:22

If you're gonna be comfortable with the status quo and you're an older doc and you're just-I mean, we've seen some of these practices where they just plateau and they just stay like that. And eventually those are the practices that don't stay, they start to dwindle down because it's kind of like a pond, right? When all of our existing patients, they've been fished out, right? All their dentistry's been done, they're on maintenance now. All the new patients have not been fished out, right? They've got lots of problems, they've got lots of issues. Like Steve said, they require us three times as much. Our practice, I'm gonna mention this here because you asked it before. Our practice, our team totally understands that we are all about getting new patients all the time. Two of our main metrics that we have involve new patients. How many new patients do we get per week, per month? What's our production per new patient? We track production per new patient. And it's always really, really high compared to existing patients. We track on our doctor board that we have every week how many new patients did each doctor see, right? This way I don't want a doctor coming up to me and saying, hey, my production's not so high. Hmm. He saw like 20 new patients last week. You know how any practices can give you 20 new patients in a week? Damn baby. We block off the schedule, like we always suggest to our clients, and they're only for new patients. Existing patients can't go there. So my team 100% understands that we need new patients to keep growing as a business. The one point that you said that is pretty interesting is sometimes you're right. Sometimes people do think that we're so high and mighty that we don't take new patients. Because the older patients, they were like, you know what? I wanted to ask you a question. My aunt, she need, or my so-and-so, my sister needs to come in. Are you taking new clients? They always say clients, right? And so, yeah, sometimes it does happen. And I always tell my hygienist and my team members that when at the end of a visit, ask, I call it the million-dollar question. Is there anybody else in the family we can get scheduled? Just always ask that. It's amazing how many new patients you can get from that one question if your whole team is asking that all the time, especially hygiene.

Paul Etchison 22:18

Yeah. And if your patient calls marijuana grass, chances are they don't know that you're you're you're you're you need new patients or that you're open for new patients. So you should let them know.

SPEAKER_01 22:28

I don't know that metric, Paul. Yeah.

SPEAKER_00 22:30

I thought it's so true. That must be from your band days, Paul.

Closing Mindset And Next Steps

Paul Etchison 22:37

So all great things, all like things to focus on. But I think the the point of this episode is man, is this an overlooked part of your practice? And damn doesn't have downstream effects. One big case comes through. You missed it. That big case could have generated two other cases from like word of mouth. And those two cases could have generated two each. I mean, like, I think this is how when you see these practices that are just seeing an insane amount of new patients. I mean, they're taking great care of people, and eventually I think it just organically grows. I know for a fact. Now we're seeing about we took a dive after, you know, we're seeing like 140 new patients a month. We took a dive after. Delta, and we still have not recovered from that completely. But I will tell you that those new patients, nearly half of them are like referrals from existing patients. Not so much of it's coming from external marketing anymore. I think it's super important. I mean, we're we're at the top of our thing. We've got the great reviews, people see us, people call, and we can convert. But at the same time, I mean, I'm not saying that my phone skills are perfect. And I don't suggest anyone call my office right now because that would be really bad and they don't need more things to do. But I will tell you that we do listen to phone calls and we've been doing it a lot for the past like three months, and it's making a big difference. And that's I think sometimes that's the hardest part about the phone skills is just having somebody listen to them. And I think there's lots of softwares that can make this really easy for you. Transcriptions, AI stuff that'll give you stats on your conversion metrics. So this is an area you're practice that is really, really worth looking at. Steve, anything else you want to say before we close it out, my man?

SPEAKER_01 24:12

Yeah, just answer the phone, be kind. Yeah. It ain't a rocket science.

SPEAKER_00 24:16

Yeah, be humble. Don't be afraid to listen to the calls, to find out what amount of calls you're actually missing. It's very humbling. Yeah.

Paul Etchison 24:24

All right. Great discussion today. You know, at the end of the day, this isn't really about the phones. It's more about leverage. Our phone systems, that's the front door to our practices. And when that door isn't being managed intentionally, everything downstream can suffer and the schedules get lighter, our production can feel unpredictable, the growth can stall. We can't see an obvious reason why, but it's right there in front of us. So when you get that right, when you get the phones right, everything else can feel calmer and more controllable. So if you remember nothing else from this episode, I want you to remember this. If you're missing calls, you're missing new patients, period. You're missing revenue, period. New patients and emergencies at your practice, they truly deserve the priority, not the leftovers. And phone skills, I don't care what you think, they're not instinctive. They require training, they require repetition, they require monitoring. And what gets measured? Well, you know what? It always improves. So that missed call rate, your schedule of utilization, it will improve if you measure it. None of this is complicated. It's just neglected. Now let's get one thing straight. You're not behind, your team isn't lazy, and your practice is not broken. You just can't expect growth without systems. And the phone is one of the most powerful systems that you have. So fix that and everything else will get easier. And if you want help looking at this objectively without judgment or pressure, head over to dentalpracticeheroes.com/slash strategy and set up a strategy call with me. I will share with you some ideas, some action items, and I'll tell you what DPH can do with you to help you live a better life through having a better practice. So no pitch, just clarity. You will walk away from that call with some action items. At the bare minimum, you're gonna learn something. So thank you so much for spending time with me today. If this episode was helpful, a quick review on Apple Podcasts can go a long way. I always really appreciate it. And as always, keep building a practice that supports your life, not one that consumes it. We'll talk again soon.