Recall is the bane of orthodontic practices. Why is that? I guess it’s all a matter of perspective but TCs hate doing recall and owner doctors hate trying to make sure TCs are doing recall. Whenever I visit an office (including my own), there is almost always a game of cat and mouse going on between the TCs and the owner docs where each tries to outsmart the other when it comes to recall. It doesn’t have to be this way. Let’s talk about a few things that, if implemented, can help you when it comes to recall:

1. Doctor, stop screwing up the new patient visit and giving the patients too much information. Think about going to a mechanic when you have an issue with your car. You don’t care what kind of wrench they will use and you don’t care about the theory behind the diagnosis algorithm that the garage’s computer uses so why do you think patients want to hear all your nerd talk? Same goes for TCs. In my experience both doctors and TCs talk way too much about things no one cares about just to try and prove how smart we are. You survived all that schooling, you have your own business and patients assume (rightly so) that you know what you are doing. That’s why they took the time and effort to show up at your office! The more you talk the more likely you are to convince them otherwise. And I don’t want to hear the “informed consent” argument. What we do is simple. It can be explained simply in layman’s terms. Stop trying to make yourself look important because it’s costing your dearly.
2. Embrace shoppers and be glad that they included you on their list of offices to visit. “I hate shoppers” is one of the dumbest, most counterproductive statements I hear from orthodontists but I hear it all the time. If shoppers don’t buy from you that means they found something better – so what does that say about you and the way you do things doctor? Plus, if you have a bad attitude about shoppers, your TC and team will too. The person answering the phone hates shoppers so the shopper gets treated poorly and then we wonder why they don’t show up. Darn shoppers… You can’t change others but you can change yourself. Just think if you made yourself more attractive to new patients, you would win more shoppers and have less recall. Change your mindset and realize that shoppers love to buy! Assume every shopper will pick you and act accordingly. The rest will take care of itself.
3. Give the patient their records at the new patient visit. Every time. For free. Why wouldn’t you? You should be digital for the decreased radiation exposure so it doesn’t cost you anything but a piece of paper. If you are still analog, take a photo of the records and print them out or email them to the patient. No matter where the patient starts, you don’t want little Susie to have to have more radiographs taken, do you? Plus, if you’re nice about giving them records the patient is more likely to see that you care and is more likely to start with you. When you call these patients for recall, you can ask them if they need another copy of the records to make yourself feel better about calling and “bothering them”.
4. Start doing same day starts. Now! If you start the patient today then there is no need for recall. It’s more convenient for the patient and for you. People are busy and going to the orthodontist is inconvenient.
5. Mindset is everything. TCs and doctors don’t like recall because they don’t want to be salesy or pushy. This is a bad way to think about recall. You didn’t force people to come see you. They came because they wanted to. That’s how you got their contact info. So use it and follow up and keep in mind that the patients who came to your office want braces. All you have to do is make it convenient, affordable and attractive to do so at your office.
6. Use a Google Document to keep track of who comes in, who signs up, who does not, who has done recall and what was said. It’s easy and everyone can see what is going on. Total transparency and tracking are key when it comes to long term, sustainable recall systems.
7. LOOK AT THE TRACKER you create regularly. It’s amazing to me how many times we orthodontists set up trackers and then don’t take the time to look at them. If you don’t monitor what is going on, those who are supposed to be doing recall will figure it out and slack off very quickly. It’s uncanny how fast this happens. This doesn’t make them bad people, just human. People respect what we inspect.
8. Spot check the patients on the tracker and pull some charts to do an audit occasionally to verify that what you are being told is accurate. I know it sucks to have to do this kind of stuff but that is the world we live in.
9. Use SurveyMonkey.com or a similar service to send a survey to patients who don’t start and ask them for help to make you better. Ask specific questions about how you could do things better. People are more likely to give you feedback if you ask it this way rather than asking them to tell you what you did wrong. Multiple choice with optional write-ins are effective. If you craft your survey and answers effectively, you will get insight into how your new patient and recall processes work and that will give you an opportunity to improve (if you’re not too set in your ways).
10. Use one of the various software packages out there to record some recall phone calls and then go over them with your TCs.
11. Role play with TCs and be sure that they are handling issues in the manner you want it done. Coach them as appropriate. Don’t be too proud to role play. It feels silly but nothing is more effective in my experience.
12. If you find that a TC is not doing what needs to be done and not getting the results necessary, you may have to make a change. In my considerable experience buying, visiting and coaching offices, I find it very rare that a TC will change their mindset. I hate to generalize but that’s been my experience over and over and over. Chairsides will change, office managers will change, front desk and admin people will change… heck, even doctors will change occasionally! But TCs just don’t change the core of who they are and what they KNOW and what they BELIEVE patients like and do not like or what patients will and won’t do. Making changes to recall and autodraft protocol are the two stickiest points that doctors must address with their TCs. These points are vital and any problems must be addressed decisively and to the benefit of the practice and all the other employees if you hope to run a successful business long term.
13. Get someone really smart like Sarah Sharfstein to visit your office and look for flaws in your process. Be transparent and stop thinking you have some secret sauce because this inhibits your ability to grow and learn. IF you are smart enough and lucky enough to have this happen and IF you are willing to listen and take criticism and consider ideas that are outside of your comfort zone then you are often presented with big opportunities. Sarah came up with the idea of sending a letter to ALL the patients who visited the offices but didn’t start in 2013 and 2014 offering them an Invisalign promotion and discount (we skipped 2015 because we are still actively working that recall list). I’ve never been a discounter but Sarah’s idea produced big results in a group of patients that were long gone and that changed the way I think about our practices. Change is good but not easy… Luckily you don’t need a big time executive to come to your practice to get started changing your mindset and making meaningful change in your practice. Get your friends and classmates to visit your office. Make some new friends on the FB groups and invite them. Go visit their offices! Being open minded while hanging around bright minds is incredibly rewarding.

Any of these thirteen points will massively improve your recall process if you will implement and adhere to them. Recall is not hard, just as being in shape is not difficult. I have considerable experience in getting out of shape in terms of both physical fitness and office systems and I can tell you that doing what needs to be done daily is far superior to losing track and having to struggle to regain lost ground! But you don’t have to take my word for it. Time and experience will teach you just as surely as they have instructed me! The purpose of OrthoPundit is to help you avoid those harsh instructors but, in my experience, most of us have to learn the hard way in our own time…