Reactivation strategy

April 1, 2012
Over the past year, we have noticed a steady decline in business. There are holes in both the hygiene and doctor schedules daily ...

by Dianne Glasscoe Watterson, RDH, BS, MBA

Dear Dianne,

Over the past year, we have noticed a steady decline in business. There are holes in both the hygiene and doctor schedules daily, but open time is worse on the doctor’s schedule. I am certain there are many people who have not scheduled needed care because of layoffs and work slowdowns in general. However, I’m also certain that some patients have fallen through the cracks and just need to be reactivated. How is the best way to do this? Can you provide some good verbiage to use when making calls?

Donna, RDH

Dear Donna,

Many dental practices across the country are noticing a decrease in demand for dental services that is a result of unemployment or under-employment. Unfortunately for us in dentistry, many people have abdicated their financial responsibility for dentistry with the advent of third-party or company-sponsored dental benefits. They think that they can’t go to the dentist if they have to pay for the treatment themselves, no matter how cost efficient preventive care is.

Here are the major reasons patients become inactive:

  • The patient cancelled the appointment and did not reschedule.
  • The patient disappointed.
  • The patient lost dental benefits due to layoff, termination, or benefit reductions in the company where he/she was employed.
  • The patient became acutely or chronically ill.
  • The appointment was cancelled by the practice because of hygienist or dentist absence.
  • The patient switched dental practices or moved and did not inform your office.

Patient inactivity is not an issue we think about until we start seeing holes in the schedule. For example, I consulted in a two-doctor practice with 5,000 active patients that was struggling to keep two full-time hygienists busy. A practice with that many active patients should be able to keep three to four full-time hygienists busy. Realistically speaking, it takes 800-1,000 active patients to keep one full-time hygienist busy.

Example —

1 full-time hygienist X 4 days per week
Appointments available in a week. 40
Multiplied by 49 weeks per year: X 49
Available appointments: 1,960
Divided by 2 (2 visits per year): / 2
Patients needed: 980

Note: This does not include any periodontal maintenance, active therapy periodontal patients, or sealants.

I believe most dental practices could do a better job with tracking those patients who become inactive over time. It’s not sexy or fun for offices still using paper charts and less-than-optimal computer systems to undertake mining of charts to identify inactive patients. Busy front-office assistants are easily distracted by telephones, other staff members, and direct patient interactions during the course of a workday. The good news is that most modern practice management software systems make it easy to identify individuals who have not been in the office for a prolonged period of time. With a few clicks of a mouse, we can run a report of all patients who have not visited the practice in 12 months or more.

Now that we have a list of patients to contact, we need a reactivation protocol. Here is what I suggest:

1. Place a telephone call. If calls are made during regular working hours, expect to leave plenty of voicemail messages. Here is a sample script:

Hi, Mrs. Jones. This is Brenda at Progressive Dental Care. Somehow, we’ve missed seeing you for a good while. In fact, your last visit was (date). I don’t know if we failed to call you or if there’s some other problem. But we’d like to invite you back. Would you be so kind as to return this call and let me work out a good time for you to continue your dental care with us? Our number is XXX-XXX-XXXX (then repeat the number). I’ll look forward to hearing from you.

Then document in the computer (or paper chart) stating that a voicemail message was left.

Please say the telephone number slowly, and repeat it. (You know how frustrating it is for someone to leave you a message with a telephone number that is spoken so rapidly that you can’t write it down without listening to the message numerous times!) Another telephone tip is this: BE SINCERE. If you sound like you are reading from a script or if your voice is unenthusiastic and monotonous, don’t expect the patient to get excited about coming in.

One more tip for placing reactivation calls is this: For maximum results, calls should be made after regular working hours. The best time to reach people is between 7 p.m. and 8 p.m. I do not recommend calling after 8 p.m. Calls placed between 5:00 and 7:00 p.m. run the risk of interrupting the patient’s dinner, so if you get an answer, be sure to ask if you are interrupting dinner (and apologize if the answer is yes). Then offer to call at a later time if that is more convenient.

2. If you do not receive a return call after two weeks, send a postcard with this message:

Dear ___________,

We’ve missed seeing you! Your last visit in our office was ____________. Remember, your teeth are meant to last a lifetime, and small dental problems can become big problems if not discovered early. We are committed to providing you with the best oral care available. Please call XXX-XXX-XXXX right away to reserve time for your professional care. We look forward to seeing you soon!

Warm regards,
Laura Hamilton, Administrative Assistant

A little handwritten note on the card makes it more personal, such as “Call soon for the best appointment times.”

3. If the phone call or postcard does not get positive results, send a letter on office letterhead stationery. Here’s a sample:

Dear ____________,

Recently, we have been in the process of auditing our patient records, and we see that you haven’t been in to see us since _________.

If you wish to remain in our active patient files, please call us to schedule a continuing care appointment.

Remember, maintaining good dental health is a team effort, and we feel honored to be a part of your team! Our goal is to help you keep your teeth for a lifetime.

However, if we do not hear from you by (10 working days), we will assume you are seeking dental care elsewhere.


Laura Hamilton, Administrative Assistant

This letter is short and to the point, and it gives the patient a deadline to act if she doesn’t desire to be banished to the realms of the inactive patients. It does not terminate the patient relationship, but merely seeks to reactivate it.

Keeping patients active in the practice requires continual diligence. When patients fall through the cracks of an inefficient recare system, the result is a hygiene schedule with too many openings. Good computer software will allow the practice to identify and track patients. However, that is just the beginning. Patients have to be contacted in some fashion, whether by telephone or mailing. This is one job that is often slid to the back burner by busy administrative assistants who struggle to keep up with the demands of a hectic front desk. In many practices, the best solution has been to hire someone whose sole responsibility is hygiene department scheduling.

Best wishes on your reactivation efforts!


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