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Inside Dentistry
August 2020
Volume 16, Issue 8

Are You Ready for the Big Dip?

Have a plan for the coming hygiene schedule dropoff

Brett Wells, DDS

Well, here we are. It's been a few months since an unprecedented shutdown that had many of us wondering if our dental businesses would ever return to normal. We've stressed, but we've gotten through the requirements for additional infection control and prevention systems, the search for personal protective equipment (PPE), and the delicate human resources dance of our teams returning to work. We've worked through convincing our patients to come see us again, we've handled COVID-19 scares in our offices, and we've stayed up countless nights trying to figure out how to get back that extra time that we need to set aside for sterilization after hygiene appointments. And here we are...

For the most part, our patients are feeling comfortable and safe about returning to our offices. Research from the American Dental Association's Health Policy Institute indicates that, as of the end of June, most offices had recovered to roughly 75% of their pre-COVID-19 patient levels, and for that, we can breathe a collective sigh of relief. In fact, many of the colleagues I've spoken with related that in June and July, they had the busiest months that they've ever experienced.

Unfortunately, many of us are so busy handling the additional backed-up demand that we are completely unaware of the potential for another crisis right around the corner. It is barreling down on us like a freight train, and it has nothing to do with a national recession or economic policy.

The Big Dip Is Coming

Remember those 8 or, for some of us, 10 to 12 weeks in the spring when we were sitting at home itching to get back to work? Remember cancelling all of those hygiene appointments? Late September will mark 6 months since the shutdown began, and if you peek at your hygiene schedule, which is typically full of pre-appointed hygiene recalls, you may see a barren wasteland of open appointment space.

Dental Intelligence, a leading practice-growth software company of which I'm a client, reviewed the schedules of their 8,000 dental offices and found that from mid-September through mid-November, the hygiene schedules are only around 17% full. For a typical single-doctor practice that is open 32 hours per week with 1-hour hygiene appointments, roughly 425 hygiene appointments would need to be added to fill the schedule back up during those 8 weeks.

But don't worry, all is not lost. I'm not here just to raise your blood pressure. The good news-yes, there is good news-is that we have time to prepare. If we prepare and have a plan, we can minimize the potential for a "Big Dip," or flatten the curve if you will, and keep our businesses stable. Let's look at some approaches to reduce the open hygiene times in your office.

Ramp Up the Marketing

Cash is vital to the survival of our businesses, and although our profession is rebounding in general, many of us are understandably hesitant to spend. However, sometimes zagging when everyone else zigs wins the race. It may seem counterintuitive, but I would recommend significantly increasing your marketing efforts to push harder for new patients, starting now. Many offices have reduced their marketing, which can make it much more effective right now. And the decreased demand will make it less expensive as well. Mailers with specials, search engine marketing, and social media ads, as well as the use of influencers and print ads, can all provide great ways to bump up your new patient numbers to fill out some of your schedule.

Reactivate Overdue Patients

For as long as you've been in business, you've likely had hundreds, if not thousands, of patients who have missed or forgotten about their dental preventative care appointments. Although it's tempting to dismiss them, these patients can be key to getting through this period relatively unscathed. Proactively contacting unappointed patients can be a cumbersome and difficult task that most of your team probably doesn't enjoy doing. Automating the process with third-party texts or emails and online appointment scheduling is a fairly inexpensive approach. Using an outbound call service can prove to be very effective as well. They use automated dialing technology to quickly call large numbers of your past-due patients and only speak with the ones who answer. These call centers typically charge for each patient scheduled, and it can get pricey, but I would argue that this effort is better than having an empty schedule and paying your hygienist to do nothing.

Adding a special to help encourage both new and existing patients to come into your office can be a powerful tool to fill up your schedule. In my practice, for example, we are offering a "COVID Comeback" special that includes a $100 account credit for anyone who comes in for a prophy during the Big Dip.

Implement a Membership Plan

Interested in a stable cash flow, more frequent recall visits, and increased case acceptance? Sounds like a perfect recipe for mitigating the Big Dip. Try implementing an in-house dental membership plan. Never has there been a time when the importance of a membership plan was more evident. During the 8-week closure, my monthly membership revenue dipped by less than 10%. Having most or all of your uninsured patients on a membership plan can help to smooth out cash flow fluctuations during the Big Dip or any other business downturn. As an extra bonus, membership plans can also make your practice much more attractive to new patients who are losing their insurance due to layoffs or cutbacks.

Add an Extra Recall

Many of your patients' insurance plans allow for two or more hygiene prophylaxis recall appointments per year instead of the more rigid "every 6 months." For these patients, you can schedule their next two appointments at once. Many of these patients who missed their appointments in March, April, or May believe that they will only be able to get a single recall visit in this year because they think they have a 6-month restriction. However, if you clearly identify these "two per year" patients, you can reach out and offer to see them twice before the end of the year. Many patients are happy to come in and take advantage of their "free cleaning."

Focus On the Business

Hopefully, you will be able to formulate a plan using these and other strategies and experience the Big Dip as merely a Little Bump. However, if your efforts fail to fill out your schedule, you can still use the lemons to make lemonade. Take the time to focus on your business. We're so often putting time and energy "into" our businesses that we don't focus "on" our businesses. If your office is less busy, rather than panic, it can actually be a good time to introduce new operational initiatives or to do some training. Communication with your team is key; sit down with them and be transparent about what's going on to keep them more engaged.

You may also determine that, despite the measures you've taken, you need to temporarily reduce your capacity. If your team members have any paid time off left, you can recommend they use it. This can also be a great time for you to close the office to take that much-needed vacation. Obviously, reducing capacity is a last resort for when other strategies fail, and we would like to keep it to a minimum.

Preparation Is Key

So that is our plan:

• Ramp up marketing
• Reach out and reactivate past-due patients
• Implement an in-house membership plan
• Add an extra recall appointment when appropriate
• Focus ON your business

I certainly don't want to add any extra stress to our lives, ramping our practices back up is stressful enough, but the Big Dip is a big deal, and it can blindside us if we're not ready for it. When I first realized it might be coming, I called some of my colleagues to make sure that I wasn't crazy, and then I called my representative at Dental Intelligence. Talking about it confirmed my fears: this is serious. However, the Big Dip is a crisis that we can actually prepare for. Whether you decide to use all of these strategies or just a few, the important thing is that you have a plan. We will make it through this and thrive!


1. Kliff S. How's the economy doing? Watch the dentists. The New York Times website. Published June 10, 2020. Accessed August 17, 2020.





About the Author

Brett Wells, DDS, is the owner of DentalHQ, an automated membership plan platform, and maintains a private practice in Raleigh, North Carolina.

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