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states. Nationwide, the average reduction was about 7%
between 2010 and 2015. The trend certainly continues.
Now, what about the patients at your practice
who don’t have insurance?
My experience is that it’s not uncommon to see practices
with as low as 10% of patients uninsured, to as high as 60%.
In the practices I work with I often see that about 35% of the
patient base is uninsured.
These patients pay your full fee (unless you have a membership
plan, which is a whole other story). You may give a
senior’s discount or a bookkeeping savings but, in a sense,
they are paying more for exactly the same level of services
than patients who are subscribers to networks with whom
you’ve entered into contracts, and therefore receive substantial
discounts.
I know that dentists and their staff are hard wired to deliver
the same level of quality to every patient, regardless of their
insurance reimbursements.
It’s never been a successful strategy to try to use cheap labs
or shorter hygiene appointment lengths when dealing with
“discount” patients while delivering better services to better
paying patients. It just isn’t something that Doctors are wired
to do or will sleep well at night doing.
So, if quality isn’t a variable, should the price be?
A lot of dentists feel that PPO participation is the key element
in how many patients they attract. Our experience has been
that PPO participation is a factor, but it’s not the only factor
or even the main factor. Your location, signage, customer
service, hours, internet presence, staff training, range of services,
and level of technology, are all factors that affect your
So Doctors, please be assured that most patients like you
for more than your “Network Participation Status.” In fact,
rephrase that question and ask your team and yourself:
Start by building trust
Trust is the foundation of a private practice. Note I said practice,
not “clinic.” It’s trust that will have patients want to stay
in your practice even though you may not offer evening or
weekend hours, deeply discounted services, free parking, or
lots of PPO participation.
A patient will put up with inconvenience, cost, and all manner
of other “imperfections” if they know you are keeping
their best interests in mind and are treating them fairly. Most
of your patients don’t really expect charity, and they don’t
want to think that their dentist is so desperate that they have
to work half the time for free to keep their chair full.
The conditions for trust are well known: Validity, empathy
and authenticity. Of these, the most important is “empathy.”
A patient doesn’t sense empathy from you just because you
accept a discounted fee schedule. A patient feels empathy
from you when you truly listen to them. Other forms of social
proof such as patient testimonials and, importantly, the full
faith and trust of your team help build trust too.
What I’m leading to is this...
When I see Doctors who are willing to work for just 65%,
60%, even 50% of their normal fees, I can’t help but think
that they don’t hold themselves in as much esteem as their
patients likely do, and they don’t realize that patients aren’t
coming to them primarily for their insurance status.
If they developed trust with patients, many patients will happily
see them out of network. As discussed in my previous
articles, you probably are already seeing some patients out of
network.
What if you sat down with your patients and asked
them, “Would you go to another dentist if you could save
money?”
Almost every dentist I know would hate to ask that question
because they would be afraid of the answer! Yet, I think you’d
be surprised at how many patients would say, “No, I like it
here.”
In fact, we recently surveyed 100 adults, ages 18 to 68, and
asked them just that: 83% of respondents said they trusted
their dentist. Of those who trusted their dentists, only 8%
said they would leave to save money. 66% said they would
not leave and 25% said “maybe” they’d leave. Of the 16%
who said they just “sort of” trusted their dentist, 44% said
they would leave to save money and 31% said maybe they
would leave.
So Doctor, ask yourself, ask your team: Are we working as
hard to gain patients’ trust as we are working to outrun the
discounts?
It’s also important that you walk the talk.
If you are cutting back on PPO participation, it’s not enough
to just leave. You have to be working toward something. The
additional revenues from gaining some control over your
fees should go back into equipment, continuing education,
and a happy, well-compensated team. Manage your practice
your schedule.
If you’re cutting back on PPO participation, you can be a bit
more conservative in what you charge, because you are actu-
and is philosophically congruent. In other words, if you can
look patients in the eye and know that they are getting a fair
deal, and if their insurance company is paying greatly less
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