As I’ve mentioned, at Smiley Face we do a great deal of communication via Facebook messenger with consumers who are shopping for braces online. These free flowing, largely unstructured conversations that take place all hours of the day/night, are driven by the consumers, can take days or even weeks to come to a decision point and are designed to get the consumers the information they want at the time they want it and in the format they desire. This process is wholly different than the traditional dissemination/gathering of information that takes place between a patient and a traditional orthodontic office. In a “normal” office the orthodontic team drives the conversation, the timeline and the information that is released while all but demanding the information we want from the consumer in an inflexible, intolerant manner. People who refuse to strictly adhere to the way orthodontic staff want this process to proceed are written off as “poor quality leads” or “problem patients” to be ignored at best and encouraged to go elsewhere at worst. While it is certainly the perogative of the orthodontist to run their practice in the manner they see fit, more often than not two things are at play in offices that have overly strict rules on patient intake/information gathering.

  • First, many of them are struggling to get patients in the door and, as a result, their business is struggling. If your business is struggling and you’re not getting the starts you need then I’d suggest you throw the traditional way of doing things out of the window along with any employees who refuse to change.
  • Second, often the orthodontist is not aware of how their new patients are treated in the initial and subsequent contacts with their office or how many new patient visits this costs them. Many orthodontists would be horrified to experience their own new patient process!

Along with the obvious suggestions of getting one’s perspective right, adjusting to the times and doing a few secret shopper calls, I wanted to take this a bit further.

At this point in the game the only thing that really matters in an orthodontic office from a business point of view is how many cases you start per day. PERIOD. Obviously, for a case start to take place in your office there are a litany of other things that must happen – you must be an ethical/honest/caring doctor, have effective marketing, proper staffing, excellent training, you must render excellent care, you must produce great results, have effective logistical systems, maintain your supplies, build and maintain your physical plant, etc. – but we will stick to a discussion of the singular, defining KPI for the modern orthodontic business:


In this context a lot of things orthodontists think are very important matter not. Things like conversion rate, no shows, tracking of every lead, verifying insurance benefits before the appointment, gathering patient info before they show up at the office and the TC process (TCs themselves for that matter) are no longer important or necessary in the modern, thriving orthodontic office. This is not to say that a thriving office cannot or should not have these things, I just want to point out that one does not need any of these things to have a thriving office. These days some of the really important things that are essential for getting your desired starts per day are:

  • Attractiveness – What we offer must be attractive to our target demographic and hopefully our target demo encompasses as many people as possible.
  • Affordability – People figure out how to afford what they want so attractiveness helps but affordability is a huge part of having a successful practice going forward – both price and financing come into play here.
  • Value – If you want to charge premium prices then you better deliver premium value and be open nights, weekends, holidays, after school, and have all the bells, whistles, coffee machines, ice cream, tchotchkes, etc. If you want to limit your hours or services or scope of treatment then you need to have a very attractive price to make up for it. Most orthodontists will live in the middle between these extremes but that doesn’t make doing so a good idea.
  • Responsiveness – We must respond to consumers when they want us to with the information they want on the platform they prefer.
  • Transparency – It’s vital that we lay our cards on the table so we don’t nickel and dime patients or give the impression of trying to pull one over on them.
  • Promise keeping – Clearly define what you will deliver and then deliver. If you cannot, for any reason, own the problem and make it right.

These days, all that matters is that your brand, marketing, results, reputation, product desirability, service level and pricing come together to drive enough consumers through your door so that you can start your desired number of orthodontic cases per day (allowing your business to thrive). How many new patients you need to see to get those starts and thus your conversion rate is irrelevant. How many times you talk to a patient or appoint a patient before they show up and/or start is not important. Whether or not a specific lead starts is besides the point as long as you get the number of starts you desire per day (recall is still vital tho!). In this context we want to give the patients the reigns and allow them to direct the entire information exchange and new patient process as well as the flow of information and the scheduling process. Of course you’ll set some parameters that are deal breakers for you – like when you see patients, what appliances you use and what cases you’ll treat to name a few – but beyond that you need to give consumers as much latitude as possible. What good reason do you have for not doing so other than “that’s not how we do it here”?

At Smiley Face our receptionists know, own and live by this mindset. They are here to help (we all are) and we will do whatever we can to facilitate the patient showing up at our office so they can see how friendly the team is, how awesome the office is and how caring the doctor is. We know our best chance to make a connection with the consumer, impress them with who and what we are, show them we have what they want and convince them that Smiley Face is the place to be is to get them in our office. We have no desire to have difficult/detailed conversations, press for information or inconvenience patients over the phone or online. We want to give the consumer all the info they desire at the time and in the way they want it and GET THEM IN THE OFFICE when it is convenient for them. How long that takes is irrelevant. How many broken appointments it requires doesn’t matter. If someone calls or texts or messages us wanting an appointment we help them get one. If they happen to have their insurance info we will take it but we don’t need anything more than a name, date and time and don’t press them for more. We don’t even need their date of birth or phone number – we can get all that when they show up at the office and if they don’t show up that’s ok too. We will try again when it is convenient for them!