Patient Communication: Moving Beyond 2 Tin Cans and a String

Dentistry Today


Just a few years ago it was considered revolutionary, but today it is clearly mainstream. Most people, particularly your patients, access it daily, and it’s likely they do so several times a day. If you and your team were to utilize it to its fullest, you could streamline the efficiency of your practice, reduce your no-shows, curb your cancellations, fill open appointments, and enhance doctor/patient relationships. What’s more, 85% of your patients prefer it! What is it? E-mail.

The majority of your patients not only are e-mailing but also are actively text-messaging. And they are scratching their heads wondering why you have yet to enter this now well-established era in the information age.

Don’t believe me? Take a look at the numbers. According to the Pew/Internet & American Life Project, the majority of Internet/e-mail users today are between the ages of 18 and 64. Ninety-three percent of those with household incomes greater than $75,000 use the Internet/e-mail, and nearly 90% of those with a college education are online.

You say you have a graying practice-consider this tidbit: Senior Magazine recently reported that it is a mistake to assume that older adults are not using e-mail and the Internet. In fact, the number of seniors online continues to swell. Among the main reasons they get online is to research health topics-dental implants, perhaps. This also happens to be the demographic that owns 77% of the country’s financial assets, according to the American Banking Association. Are you beginning to see the opportunity here?

If you’re not using e-mail to communicate with your patients, perhaps it’s time to rethink your strategy-or lack thereof. Reaching today’s patients requires that you communicate with them using today’s tools. The telephone and postal service aren’t delivering the results they once did because communication habits have changed. But this isn’t just about your patients. This is about your practice and what e-mail and the Internet could do for you and your team, provided you’re open to working smarter and not harder.

Services on the market today are tailored specifically to addressing the unique needs of the dental practice. For example, electronic appointment cards-or e-cards—detail the patient’s scheduled appointment and allow the patient to save the date in his or her electronic calendar on a computer or personal digital assistant (PDA). E-mail reminders are sent to patients at predetermined intervals to remind them of upcoming appointments. Appointment confirmation via e-mail allows the patient to verify that he or she will make the appointment with a single click. Even more interesting are the scheduling programs that enable patients to schedule or reschedule their appointments via e-mail-no phone calls, no waiting on hold, no telephone tag. And your patients can do that 24 hours a day, while your staff is on a lunch break, outside business hours, and over the weekend. This is a no-brainer. But there’s more. Read on.

Illustration by Brian C. Green

E-Recall: Cost-effective,Time efficient

Recall. It’s the afterthought of the dental practice. Oh yeah, when Mary the hygienist has time between patients, she is on the phone trying to drum up business. When Mary is on the phone, the practice is losing money and patients. In fact, most patients who drift away are lost because of ineffective—or virtually nonexistent-recall systems. And practices routinely fail to measure the critical importance of recall until they are looking at desperately depleted patient rolls and crumbling production reports.

Rarely is recall managed effectively, yet it is a huge production generator. The reason? Often practices are reluctant to invest the time and personnel in maintaining an effective recall system. Yet by using e-mail, practices can quickly, efficiently, and cost-effectively remind patients of upcoming appointments without ever picking up the phone. It’s the no-pain, plenty-of-gain answer to those who dread dealing with the tedium of recall or feel they don’t have the resources to plant someone on the phone for a couple of hours a day.

Integrate a new system in which you incorporate e-mail reminders to patients due for upcoming appointments. I recommend services that make it easy for you to contact the patient via e-mail 2 weeks in advance of the appointment and again 3 days prior to the scheduled visit. The patient should be able to confirm his or her appointment electronically with either reminder. For the few who do not electronically confirm, initiate follow-up phone calls 2 days before the scheduled appointment.

A recent study by surveyed 10,000 people and found that 85% prefer communicating by e-mail rather than by phone. How much more efficient would your business staff members be if they didn’t have to contact 85% of your patients to remind them of upcoming appointments? How much more effective could you be if you knew that 85% of your patients would be in the chair at the designated time and your business team could focus its efforts on shoring up that remaining 15%?

From My Doom to My Boon-Stop Cancellations and No Shows

Last-minute cancellations can send production into a tailspin and your staff scrambling to fill punch bowl-size gaps in your day. The employees are frantically calling patients one by one, and other duties-like collections-are cast aside to put out this 5-alarm production fire. But what if you could instantaneously contact specific patients on an “as-soon-as-possible” list via e-mail or a text message sent to their cell phones? The first patient to respond is given the appointment. And just as fast as that unexpected cancellation cracks open your ideal day, you have another patient scheduled in that slot. The business employees aren’t in a 9-1-1 panic to fill the time, and the process is simplified considerably.

Although the thought of allowing patients to schedule or reschedule their own appointments might send some dental teams into something resembling anaphylactic shock, for those willing to try this 21st century approach the results are truly impressive both in terms of saving staff time and reducing no-shows.

The better dental practice e-mail programs use a “smart appointment request,” which works like this:

The practice sends an e-mail notice to patients informing them that it is time to schedule their appointment, or the patient indicates that they need to reschedule. The program allows the patient to view 3 possible appointment options based on the scheduling “rules” established by the practice, so the practice has control. The patient selects one of the available times or requests additional options.

After the patient selects the desired appointment, the front desk confirms the request and enters the appointment into the practice software. Shortly thereafter, the patient will receive an electronic appointment card and reminder notices. The staff isn’t sitting on the phone with the patient, paging through the schedule, trying to find the right appointment time and date for the patient. The patient determines what will work best for them in just a few clicks and books it. This is what working smarter, not harder, is all about.

E-mail + Patient Education = Treatment Acceptance

Eight out of 10 of your patients are Internet users. These people are information hungry. When they consider a purchase, when they are exploring a topic, when they want to know how to do something, they turn to the Internet, and they routinely visit specific sites. While you may not have a Web site (and should consider developing one), in the interim you can begin providing patient education via e-mail. Send an e-mail newsletter to patients on a regular basis. It doesn’t need to be elaborate and contain all the bells and whistles. In fact, patients prefer fast to flash. But use it to educate your patients by focusing on just 1 or 2 topics that you can touch on in a couple of short paragraphs.

Tell them about a new (or old but undiscovered) service you are offering. Tell them about the continuing education that you and/or your team recently completed and how it will benefit them. Give them information on dental topics they are seeing in the news media-such as whitening, implants, and the link between oral health and cardiovascular health. Direct them to a credible Web site such as the ADA for information on fluoride or the use of amalgam restorations.

It doesn’t take an elaborate study to recognize that if you educate patients on the best treatment you have to offer through e-mail and a Web site, if you communicate with patients via e-mail routinely, if you become a trusted and knowledgeable resource for them, your doctor/patient relationship now extends well beyond that 3-minute oral hygiene check that you perform every 6 months. And your patients are far more open to not only accepting your treatment recommendations but asking you about the services they now know you offer.


Start collecting e-mail addresses from patients today. Explore the full range of e-mail services available to streamline your day-to-day operations, and use e-mail to build your doctor/patient relationships. The Internet is far more than an information tool; it is a way of modern life and modern dentistry.

Ms. McKenzie, certified management consultant, is a nationally known lecturer, author, and consultant to the Council on Dental Practice of the ADA. She is CEO of The McKenzie Company, which has provided success-proven management systems to dentistry since 1980 and offers a full line of educational management products at She is founder of The Center for Dental Career Development, which provides advanced education to the dental profession online at or in La Jolla, Calif. To receive Ms. McKenzie’s weekly e-management newsletter, which provides targeted management tips, call (877) 777-6151 or e-mail For more information about e-mailing patients, visit