Eureka!
I finally figured out something I’ve been pondering for over a month. I used to think a high conversion rate was important. Then I thought that conversion rate was irrelevant. I was wrong on both counts. Today I realized that a high conversion rate is actually a sign of an unhealthy patient mix and a shaky financial future for the practice. Bear with me here… if we get so few patients in the door that we have to start almost all of them to hit our goals then basically we are subsistence farmers who only produce enough to get by and if there is any change in the external forces that act on the practice we will likely go into starvation mode. Also if we must start every patient we can with zero selection criteria other than they are willing to start that explains how we get all those PITA patients in the practice that accumulate over the years (PITA in terms of treatment, attitude, entitlement, etc). If, on the other hand, we have enough foot traffic in terms of new patients that we don’t have to start everyone – or even better that we CAN’T start everyone – then a few things happen:
1) We start the most eager, least demanding, most compliant cases – those who don’t love what we do will self select out of the process.
2) We have the option to choose the easiest cases which are much more profitable and less taxing.
3) This excess insulates the practice from changes in environmental effects that are beyond our control.
Based on weeks of thought and this revelation I’ve decided that I now want enough new patient flow to depress my conversion rate below the 60% mark. I believe a conversion rate in the mid 50s and a massive number of starts a month are much better indicators of a healthy, sustainable practice than the metrics we have consistently followed in the past.
I really like the thought process here Ben and it makes me think of the many cases I probably should have passed on but am now stuck with.
Do you have any good scripting for letting a patient know that you’re not willing to treat their case? I’ve had some rather unpleasant responses from patients when I’ve done this in the past and haven’t figured out a good way to let them know they’re not a good fit for the practice and have them leave happy.
Thanks
I get this question almost every time I discuss this topic with an orthodontist so I’m glad you asked. Obviously something in our training has led to this collective mindset and fear but I’m not sure why. It may also come from decades of having barely enough new clients and the necessity of starting everyone? But I also know that most orthodontists don’t treat craniofacial cases, clefts or behavioral problems – these are usually referred to a Childeren’s Hospital or to someone who focuses on treating those casss and orthodontists don’t have any issue sending these cases on. The same mental process applies. There is a very small percentage of patients who I won’t treat because I’m not set up for it. Read the article What Does The Average Ortho Patient Look Like? and this may help as well. I had a patient come in yesterday with a 10 mm anterior open bite and significant anterior crowding and I simply explained to her that we don’t treat such difficult cases – cases that would likely involve a long treatment time and surgery and I referred her to a colleague who was glad to have the case and who charges 2-2.5 times more than I do. It’s pretty simple.
That being said we orthodontists are terrified as a group of confrontation and we tend to remember that one time at band camp when a patient got upset and make policy based on the outlier. No matter what you do, if you see any kind of volume, someone will get upset. Such is life. Know this, deal with the outliers as they occur (and not before by worrying) and do what is best for the majority of people and your pracrice. I’m only two days into the official opening of my proof of concept so we will have to wait and see what happens but I believe the model I’m pursuing will be a lot of fun, increase access to care and be very rewarding. We will see.