Inside Dentistry
July 2012
Volume 8, Issue 7

Dental Business CPR

Make better business decisions so you can have a better practice.

By Mark T. Murphy, DDS, FAGD

It is a bit of risk to borrow this acronym and apply it to the business of dentistry. Not because the letters lack accuracy (Conversion, Penetration, and Retention), but rather that cardiopulmonary resuscitation is a first-responder reaction to a potentially catastrophic event. "Dental Business CPR" is a way to frame analysis, planning, and systems in your practice so that you can do more of the dentistry patients need, help them to have healthier mouths, make more money, and enjoy less stress. CPR could and should be used every day to help orient practicing clinicians toward making better decisions that are aligned with the practice’s vision, goals, and objectives.


Sometimes how we look at the problem is the problem.

Economic downturns do not really create the problems in dental practices; they simply magnify them. If strong systems have not been developed to help dentists to be effective, then weak or non-existent systems break down more rapidly when the GNP struggles, markets fall, and unemployment rises. During the recent recession and really slow recovery, the author hears from many dentists that they need more new patients. However, because of the lack of systems in the practice and by not thinking inside a "CPR" framework, the way dentists are looking at the problem is the problem.

A dentist recently shared that he had holes in his schedule and had to cut back another half day of hygiene as well. He "needed" more new patients. When the author asked how many new adults he was seeing in the previous 12 months, the answer was 15 per month. With 15 new clients, times 12 months, needing hygiene visits at least twice a year, this practice should "need" an additional 45 8-hour days of hygiene this year, not less (15 x 12 x 2 hours = 360 hours, or 45 x 8-hour days). The author suggested he had a retention problem rather than a new patient deficiency.

Few practices track how many hygiene patients leave that day with a specific time and day appointment for their next recall appointment. Most think the percentage is much higher than reality. Look back at last month’s schedule and go through 100 patient hygiene appointments in sequence and check to see how many have a appointment scheduled, not just a reminder to call. Accept whatever that reality is and then pledge to change behaviors to improve it. Simply measuring it will generate an increased percentage. When everyone knows something is being measured and monitored, they tend to manage it better. Consider using one of the social media/e-mail systems (such as Demand Force, www.demandforce.com) to customize how you confirm appointments. For me, a text or e-mail is much better than hoping your Garfield-the-cat flossing reminder card got read, but for others that might be perfect. One size does not fit all. If appropriate, create more value for the next hygiene visit. Make a note and tell the patient you will re-check something in 6 months when they return. Take a photograph, use the intraoral camera, and mention that you will track the progress improvement next time.

Celebrate things with your patients. Just think how good you feel when people remember you were going on a cruise, had kids getting married, or asked about the grandkids when you come in to a retail location. This makes it feel more personal and intimate. When confirming by phone, you may use the hygienist’s name and say they are looking forward to seeing that patient for their appointment (if true), rather than referencing it as just a cleaning at 2 pm next Tuesday.


The old model of doing an examination, going to our caves and working up the case, and then presenting the solution has limited efficacy in today’s knowledge-rich and relationship-based practices. If we can instead take some time and involve the patient in the examination, they may become more curious and co-discover things with us as we gather data.

We used to call this educating the patient, but it is more than that. It is creating an environment for the patient to become aware, interested, and trusting of you. When they arrive there, and if we are patient, they will ask us what we think they should do about their dental problems. Isn’t that what we want, the patient to see us as their trusted dental health advisor? They will have taken ownership and want a solution.

People always have money for what they want. Bottled water at $1 per pint is more than twice the cost of gasoline to run our cars. But people want bottled water so they pay with ease, although tap water is $1.50 per 100 gallons and is significantly safer (municipal water quality is monitored 24/7 and bottling plants are not). Consider staying in the problem-definition mode and not telling them the solution until they are ready to hear it. We tell too much and should ask more about what the patients think about the problem. Our goal should be to help patients want what we know they need. Not simply tell them that before they understand the value. Consider not telling a patient that they need a crown when they ask what you would do to fix that tooth. Ask them instead if they would want a solution that will last several years or the rest of their life? Do they want it to look tooth-colored, or silver or gold? Sell the features, advantages, and benefits of the crown, not the "crown itself."


If we begin measuring, monitoring, and managing "Retention" and "Penetration" first, more patients stay and accept treatment recommendations. Our schedules will be fuller and, now, we may be too busy to accept more new patients. We may want to grow and hire an associate or maybe we just started the practice. What can we do?

First consider the major options, external or internal marketing to attract new patients. Both work, but everywhere the author goes practices relate that most of their good new patients come from existing client referrals. We can drop hints and nudge people to think of us when they are with other people they might refer. Thanking them in person or developing a loyalty program that rewards referrals is helpful. But the single most impactful thing we could do is to simply ask them to send a friend.

Chose a few select patients in your morning huddle that you like and who like you. When they are in, simply say something like, "Can I ask your help with something? We’re not trying to be the biggest practice here in Anycity, in fact, if everyone wanted to come here and see us we couldn’t possibly do that. So, whether or not we want to, we have to be a little selective about whom and how many new patients we have. That’s where I need your help. We have really enjoyed working with you and doing (fill in the dentistry you have done); you are the kind of patient we like to work with. If you should happen to think of someone who would be right for our practice, could you give them our name or a card?"

Do not expect them to go home and use their Rolodex to call their friends. But when they are at work, a party, or interacting with others, and someone starts talking about dentistry or their dentist, your patient may drop your name favorably. This technique has worked very effectively to get more of the right new patients.


By framing your choices about select practice behaviors with a "CPR" approach, you can develop systems that support your vision of how you want to practice. It is far more effective than trial-and-error or solving problems that we are looking at the wrong way. These concepts feel awkward at first because we did not go to business school. But we are a business. By applying CPR you can practice dentistry the way you want, help more patients, and enjoy less stress.

About the Author

Mark T. Murphy, DDS, FAGD | Dr. Murphy is the Lead Faculty for Clinical Education at Microdental/DTI Dental Technologies Inc. He also serves on the adjunct faculty at the University of Michigan School of Dentistry, is a guest presenter at Mercer Advisors, and serves on the Board of Directors of the Pankey Institute. He practices general dentistry on a limited basis in Rochester, Michigan.

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