Balancing Patient Acquisition and Retention in Your Dental Practice


A recurring topic that arises with every practice we work with is the delicate balance between acquiring new patients and nurturing the loyalty of existing ones. It's an aspect that numerous dental offices, driven by the desire to expand their patient base, often overlook. However, it is crucial to emphasize that your patient attrition rate holds equal significance to your rate of new patient acquisition.

In this blog, we provide a simple yet highly effective way to monitor and manage this intricate dynamic. Leveraging our extensive experience working with practices, we have developed a two-part system that consistently yields remarkable results. Today, we are thrilled to share this system with you, providing invaluable insights to enhance your patient retention strategies and elevate the growth of your practice.


A Two-Part System to Manage Patient Attrition

Step 1: Revitalize Your Recare System

Begin by establishing a clear deadline for when patients are considered "timed out" and marked as lost. While the standard recommendation is a two-year mark, we advise implementing a threshold of 18 months since their last visit. Why 18 months? The reason is simple: between 18 to 24 months, the cost of retaining a patient tends to rise significantly. If you have invested in a robust CRM system, you can leverage a low-cost email or automated text reminder service during this period to engage patients and encourage them to schedule an appointment. It's a non-intrusive way to remind patients who haven't visited in a while that they are overdue for an exam.

Step 2: Establish a Coding System

The next crucial step is setting up a coding system within your Patient Management System to measure patient attrition. We recommend creating a set of codes that allow you to track the reasons for patients not returning. This coding system serves as a valuable tool to analyze your patient base on a monthly basis, identify attrition trends, and forecast hygiene capacity. To establish the coding system, select a code, such as 75, to represent lost patients. Then, for each specific reason for a lost patient, assign sub-codes like 75.01, 75.02, and so on. By utilizing these codes, you can effectively track and monitor patient attrition. We suggest pulling a monthly report of unscheduled patients who are 18 months past their last visit at the beginning of each month and assigning the relevant lost patient code to them. This monthly patient attrition report will show you how many patients you are losing per month, allowing you to compare that number to how many new patients you are gaining. You can then use these trends to create a predictable growth pattern and set your hygiene schedule to account for the growth of your practice.

For example, if your practice is averaging 40 new patients a month with an attrition trend of 14 patients per month, you have a net growth of 26 patients. Multiply the number of growth patients by your standard hygiene appointment to determine the parameter for scheduling your hygiene columns. This ensures you don't over- or under-schedule your hygiene appointments.

The system is straightforward yet highly effective in providing measurable insights to manage patient attrition. By implementing this two-part system, you can strike a balance between patient acquisition and retention, leading to the sustainable growth of your dental practice.

This System in Action: A Real-World Example

We recently had a meeting with a client’s office manager who was struggling with allocating hygiene hours between their two practices. She was concerned with the hygiene capacity in one office and made the decision to move a hygienist to the other location to “help see patients.” She was feeling the effects of same day cancellations and the inability to fill those holes.


When we discussed this topic, it was clear through the dashboard and KPIs that we put in place that even though they had averaged 2-3 cancellations per day the resounding year-over-year numbers were showing positive growth. The practice was averaging a gain of 30 patients per month after accounting for an 18-month aged patient attrition.


We went over the forecast of their new patient to attrition rate, and they are going to be out of chair space by the end of 2023. Even looking at the future schedule they are booked out 7 weeks with limited access for new patients to be scheduled. The data points provided from this system clearly showed the office manager she should be thinking of expanding the schedule instead of condensing it. Without the proper data points from this system however, she would not have been able to make a sound decision.


This system is incredibly insightful as it helps you understand your practice's hygiene capacity. Many dentists find themselves baffled as to why their schedules aren't staying full. The answer often lies in unchecked patient attrition. Despite stellar marketing efforts, if you aren't addressing systemic issues causing patient attrition, your practice size might still be dwindling.


The Bottom Line

Running a successful dental practice isn't solely about acquiring new patients - it's about maintaining a healthy balance between new patient acquisition and current patient retention. It's crucial to understand and manage your patient attrition rate effectively. If you don't, even the most effective marketing efforts may not prevent your practice size from shrinking. I hope you find this two-part system useful and can implement it to enhance your patient retention strategies. Remember, every patient in your chair is an integral part of your practice's success. If you need support in optimizing your practice's growth and profitability without adding more chair time, we offer tailored consultations to address your unique needs. Don't hesitate to book a consultation and take the next step towards maximizing your practice's potential.