By Jamie Reynolds

In case you haven’t been paying attention to Ben lately (read: hiding under a rock), same-day starts are important…like really important.  A couple of years ago, I wouldn’t have believed it myself.  We were doing what we had always done – trying to not be ‘pushy’ with our patients.  No doctor wants to be ‘salesy’ and we certainly didn’t either.  So, in our effort to avoid what we considered to be ‘salesiness’, we wound up being dumb and missing the fact we weren’t giving the patients what they actually wanted, which was to get their braces on quickly and conveniently.

All the same-day start talk got me thinking about what I would want if I was in the office with my children.  I am pretty darn busy these days as are seemingly everyone I know.  Whenever I make appointments to do anything, I try to get as much done at that appointment as possible in the least amount of time possible.  So, why wouldn’t our patients think similarly?  The answer is: they do!

A few years ago, Jeff Kozlowski, Dave Ternan and myself founded OrthoFi.  For those unfamiliar, it is a software, service and consulting company that helps create a seamless process that flows from the new patient phone call, to the forms, and on to the new patient exam with innovative and intuitive software…like an orthodontic CRM.  Once the patient starts treatment, all insurance and patient receivables are handled by OrthoFi.  To date over 30,000 patients have started treatment through the system, yielding a mountain of point-of-sale data about buying trends of today’s orthodontic consumer as well as conversion benchmarks for orthodontic offices.  My agenda here is not to advertise, but rather to give you context around the metrics I reference next.  I wanted to share some of the cool new data we are finding.  There is certainly no better place for same-day start data than Ben’s blog.

First, for the ‘no-duh’ statistic:  100% of all patients who get their braces on the same day of the NPE sign the contract and start payments.  100%.  Like I said, no duh.  If the patient does not get their braces on the day of the New Patient Exam (NPE), but does sign the contract and make the down payment, 98.6% of them actually start.  So, you might occasionally have someone flake on you after you do records and treatment plans, but if they sign the contract and make a down payment, pretty much everyone continues.  I speak with lots of doctors who are worried the patients will default if they make a low down payment on an Invisalign case but the reality is this very rarely ever happens.  Requiring all Invisalign patients, or any patient really, make a high down payment protects you from one main thing: growing your business.  It does not offer much protection from default.  But, this is an entirely different conversation.  I digress.

Now, for what I consider the fun stuff. If the patient neither gets their braces on nor signs the contract on the day of the NPE, BUT they do schedule their start/records visit the same day as the NPE, they are 80.4% likely to start. This isn’t nearly as nice as 100% or 98.6%, but 80% conversion rate is stratospheric compared to most orthodontic offices.  In my past life as a ‘non-salesy’ orthodontist, we would never ask people if they would like to schedule their records when they were in the office. We would let them know to ‘go home and think things over and call us with any questions’ or ‘talk things over with dad and we would give them a call next week to answer any questions’. Not smart.  Not smart at all.

OK, so what happens if they leave the office without braces, without signing the contract, or without scheduling their records?  What’s the conversion percentage from there?  Well, we’ve measured the decline of conversion rate from the day of the exam and how it erodes (even separated by child/adults), and the final conversion rate blends out to…wait for it…49.4%!  Meaning, if the patient leaves the office without starting or scheduling, your chances of starting them are no better than a coin-flip.  Remember, this isn’t my opinion. This is data gathered from 85+ offices around the United States from over 60,000 new patient exams.  If you hadn’t figured it out yet, Ben was pretty smart jumping on the same-day start train a while back.  Once a patient leaves the office without an appointment the chances of them starting immediately decrease by half.  More if your pending management procedures aren’t buttoned up tight.

A note for those with multi-step consultations: conversion percentage should be measured for all exams you recommend treatment and not for all those who come back for the two or three-step consultation.  If you have a 3-step consult and say ‘my conversion is 90%’ your true conversion is surely not.  Many people will not come back for the extra consults thereby artificially inflating the true conversion and giving you a data set that misleads the doctor into believing they are much better at conversions than they actually are.  You measure conversion percentage by # of patients who start treatment divided by number who were recommended treatment.  #starts/#recommends.  Measuring the wrong way can make your ego feel good while letting massive amounts of production slip away.  And, for those of you who don’t look at your conversion rate or measure conversion percentage by the simple case acceptance metric (#starts/# new consults): your conversion is not as good as you think it is.  Ask me how I know.  Yup, I went for years not measuring conversion, thinking I was pretty great in the TC room, only to face a harsh reality once I had clean conversion metrics.  My conversion stunk…another thing we learned the hard way.  If you aren’t regularly monitoring and correctly measuring your conversion, it’s likely less than 50%.  Imagine the amount of wasted time, energy and profit resulting from converting barely half of the patients you see for a new exam.

So, here’s the quick moral of the story to maximize conversions in your office:

  • Do Same-Day Starts.
  • If you can’t put the braces on that day, ask for them to sign the contract and start the down payment.  You will be surprised how many say yes if you simply ask.  If you do this, 98.6% of them continue.
  • And, the bonus tip: if they don’t start that day be SURE to ask them if they would like to schedule the records/start.  If you don’t, your chance of converting the patient falls off a cliff the moment they walk out the door.
  • Learn to measure conversion the right way.  #starts/#recommends.

Hopefully, this level of clean data acquired from practices all over the country will persuade you to implement same day starts.  The tips listed above will make a world of difference in your conversion, your profitability, and perhaps your continued ability to sustain your practice.  It has for me.


Author Biography: Dr. Reynolds attended the University of Michigan for both his undergraduate and dental studies. While at Michigan he was a member of the volleyball team, where he earned both team captain and All Big 10 honors. Following dental school, Dr. Reynolds attended the University of Detroit-Mercy where he earned a master’s degree in Orthodontics.  Dr. Reynolds has an intense desire to excel in orthodontics has become a world leader in digitally customized orthodontic treatment.  He was the first Orthodontist to include an Insignia case in his ABO recertification examination. He currently travels across the country and world teaching other doctors topics he is passionate about.  Born and raised in a suburb of Detroit, Dr. Reynolds is also intensely passionate about making world-leading orthodontic treatment affordable for everyone.  With this in mind, he co-founded OrthoFi, a company designed to help doctors deliver leading-edge care in an affordable way.  In his spare time, Dr. Reynolds loves to read, travel, spend time with his wife and three adorable kiddos, play beach volleyball and tinker with all things Apple.

2 thoughts on “Same-Day Starts – The Data!

  1. What is the industry average % for #starts/#recommends for new patients and what is that % for those patients in observation?

  2. Thanks for the question Kristi! There is a difference between industry average, what you should be aiming for and what you should consider acceptable. Also, most people don’t measure conversion this way and use the easier to calculate (though much less meaningful) ‘case acceptance’: #starts/#NPE. So, answering your question requires quite a bit of speculation on my part to apply to ‘industry average’ since most don’t measure true conversion.

    What we are seeing is that people who are not measuring starts/recommends typically are around 45-50% conversion when we first start measuring them. Sometimes worse if they weren’t measuring anything (conversion % or case acceptance). I would suspect if you could see true numbers industry wide the ‘average’ would be somewhere between 40-50%. Also, it is not uncommon for adults to convert 20% less than kids. the rates I speak about are blended with both adults and kids in the calculations.

    Now, what should be your average? I think with proper measurement and a little training, the industry average could easily be a blended (adult and kids) of 65% or better. Top performers convert over 80%. Hopefully, these numbers give you something to measure against.

Comments are closed.