Are you noticing a downturn in exams/starts? Is it because your referring dentists are retiring? Is it because you are not putting on an impressive exam? Are local dentists doing a lot of orthodontics (braces or aligners) at a much lower fee? If so, maybe this pearl can help you maintain/build your practice.
If you have a mature practice (>30 years) you may be seeing a drop in referrals as your referring dentists retire. The best way to deal with this is to hire or partner with a younger orthodontist to stimulate younger DDS referrals. If not realistic, you need to better control your OBS recall patients (a major source of starts in mature practices). If not realistic, using aggressive advertising, or incorporating plastic aligners (to stimulate adult patients) may help. Refer to the "Plastic Aligners Pearl" to help you decide on them or not. In general, you need to recreate how you deal with your present and possible referrers or accept a smaller practice—enough said.
If you have too many will-call-back patients (greater than 12% of your exams) or too many no-Tx-wanted patients (greater than 5% of your exams) it may be due to your higher fees or that you do not impress them as being worth your fee. If you put on a “great show” at the exam, making the patient the subject and not the object of the exam, it really doesn’t matter what your fee is. See the attached “Exam Critique” checklist to see if you are doing all that you can to wow them. Also refer to the “Selling Orthodontics” pearl to make sure that your sales technique is up to par.
The best way to deal with many will-call-back patients is to give the best possible service at your exams so that they won’t even think of going elsewhere. This is especially true if the patients are second opinions, whether before or after your exam.
To deal with second opinions before your exam (you are the second opinion), the best thing you can do is give them a "great show" at the exam so that they won't go elsewhere. It may also help to review your version of the attached “Wise Shopper Comparison Checklist” with them to see how well the other DDS/Orthodontist handled their exam. You can edit the Word file to fit your practice.
To deal with a second opinion after your exam, give the “Wise Shopper Comparison Checklist” to the patient/family to fill out after seeing another doctor; if not obvious, your TC manual gives the details for its use.
In any case, you might also mention to the patient that you will be happy to review the other dentist’s treatment plan (no matter who is the second opinion) and make suggestions to get a better treatment result. If a general dentist is your competition you might also mention: “most general dentists doing orthodontics don't realize how many cases exceed their ability to treat them”. This is something the patient will realize once you review that dentist's plan with them; don’t put the competition's treatment plan down, just show where it might be improved. In many cases the treatment is simple and the DDS can handle it. If so, you can reassure the patient that it shouldn't be too much of a problem having the DDS treat them. In essence, you want to be the "good guy" and help them even if you don't eventually treat them. They will appreciate it and in many cases just decide to be treated by you, especially if you do an impressive exam.
If the DDS is charging a much lower fee, you might also emphasize (nicely) that the DDS is not trained in orthodontics and that they (the patient) may be taking a chance on the final result and that the lower fee may not justify a compromised treatment. In too many cases an untrained DDS’s treatment is so poor that the patient ends up at the orthodontist's office for re-treatment; this eventually works to your advantage. If a higher fee situation, you might also give the patient a "Records Fee Deal", giving them a $400-$500 reduced fee (taken off of their initial payment) if they sign up TODAY.
