FIELD NOTE 005

Question: Before we spend more to acquire patients, do we know how many of the patients already reaching us are actually progressing?

Health Path: Patient + Practice

Status: A measurement discipline we are actively developing

From the field

When the schedule gets light, we all freak out.

Why are there so many openings?

Why aren’t the ads working?

Should we increase the marketing budget?

Do we need a new offer?

Should we hire a different agency?

Marketing is one of the most visible levers in a dental practice. When the schedule is empty, attracting more new patients feels like the obvious solution.

But then you start exploring the patient journey.

You look at the last two weeks and discover that only 50% of your incoming calls were answered.

Then you dig deeper.

Of the prospective new patients who actually reached someone, only 50% scheduled an appointment.

Then you look at yesterday’s patients and discover that only 30% scheduled their next needed step.

Suddenly, the marketing problem looks very different.

The ads may be working.

The patient journey may not be.

The math behind the journey

Imagine that 100 prospective patients call the practice.

If we answer 50% of those calls, 50 people reach someone.

If 50% of those callers schedule, 25 people make an appointment.

If 30% of the patients we see schedule their next needed step, fewer than eight of the original 100 callers make it that far—even before accounting for cancellations and no-shows.

• Prospective patients call: 100

• Calls answered (50%): 50

• Answered calls scheduled (50%): 25

• Patients schedule the next step (30%): 7.5

We can buy another 100 calls.

But if the journey remains the same, we should expect a similar result.

That does not mean marketing is unimportant. Practices need new patients, and effective marketing can create tremendous value.

It means that marketing cannot repair a broken patient journey.

The Health Progress question

Most practices measure how many new patients they acquire.

Far fewer measure what happens to those people at every transition that follows.

Did we answer when they called?

Did we make the first appointment easy to understand and schedule?

Did the patient arrive?

Did we help them gain a comprehensive understanding of their health?

Did they understand the recommended plan?

Was the next appropriate step clear?

Did they schedule it?

Did they continue through the full plan until disease was controlled and health was rebuilt?

A person can appear in the “new patient” report while making very little actual progress.

The practice may celebrate acquiring 100 new patients without recognizing that most of them became stuck somewhere between the first phone call and completed care.

This is not only an economic problem.

Every number that disappears from the funnel represents a person who had enough concern, discomfort, curiosity, or motivation to contact the practice—but did not ultimately receive the help they needed.

That is why I increasingly believe the unit we should manage is not simply the new patient.

It is the next step.

The opportunity already in front of us

When we discover that patients are falling out of the journey, there are two important conclusions.

First, we may not need more marketing to create the next increment of growth.

There may already be significant opportunity inside the patients who are calling, visiting, receiving diagnoses, or beginning care.

Some are waiting for a call back. Some never scheduled after an emergency. Some have an incomplete plan. Some began treatment but lost momentum. Others may be healthy but overdue for the care that will help them remain that way.

The opportunity is not theoretical.

These are people who already know the practice. Many have already expressed a need. Some have already placed their trust in us.

Second, improving the journey dramatically increases the return on future marketing.

Consider a different version of the same 100 calls:

• We answer 80%.

• We schedule 75% of those callers.

• We help 60% of the patients we see schedule their next appropriate step.

The same 100 calls could now produce 36 patients with a scheduled next step rather than fewer than eight.

• Prospective patients call: 100

• Calls answered (80%): 80

• Answered calls scheduled (75%): 60

• Patients schedule the next step (60%): 36

That is nearly five times as many patients reaching the next scheduled step without generating one additional call.

These figures are illustrative, and every practice’s results will be different. But the compounding effect is real.

A small improvement at one transition helps.

Improvement across several transitions changes the economics of the entire practice.

What we’re trying—and learning

We are learning to look at the practice as a series of Health Progress transitions:

Interest → Connection → First appointment → Understanding → Plan → First step → Active care → Health → Protection

Each transition has its own friction.

A low answer rate is different from a low scheduling rate.

A patient who does not show for the first appointment needs different support from a patient who completed an examination but did not schedule treatment.

A patient who is uncertain about the plan needs a different conversation from someone who wants care but cannot find an appointment time or workable financial arrangement.

When all of those patients are grouped into one category called “unscheduled treatment,” we lose the ability to understand what they need.

The answer is not simply to tell the team to convert better.

We need to identify where patients become stuck, understand why, and improve that specific transition.

That might mean:

• Better phone coverage.

• Simpler scheduling.

• Clearer network and insurance explanations.

• More consistent care presentation.

• A clearly documented next step.

• Better financing support.

• More useful follow-up.

• Greater appointment availability.

• A more coordinated handoff between the clinical and support teams.

Care Progress helps us see whether those changes are actually helping patients move forward.

This is not marketing versus operations

I am not suggesting practices should stop marketing until every internal process is perfect.

No process will ever be perfect.

The better question is whether we understand the performance of the journey before adding more people to it.

Marketing fills the top of the funnel.

The patient experience determines how much health—and how much economic value—the practice ultimately creates from that investment.

When the journey is working, marketing becomes more valuable.

When the journey is broken, additional marketing can simply make the leaks more expensive.

Before we buy more attention, we should understand what happens to the attention we already have.

Try this in your practice

Review the last two weeks and write down:

• Total inbound calls.

• Percentage of calls answered.

• Number of prospective new-patient calls.

• Percentage of those callers who scheduled.

• Percentage of scheduled new patients who arrived.

• Percentage who left with a clearly documented next step.

• Percentage who scheduled that next step.

Do not begin by blaming the person responsible for the lowest number.

Begin by asking:

• What does the patient experience at this transition?

• What friction is making progress difficult?

• Is the expectation clear?

• Does the team have the time, skill, and tools to perform it reliably?

• What is one change we could test?

Improve one transition, measure it again, and then move to the next.

Compare notes

Where is the largest patient-progress leak in your practice right now?

Is it answering the phone, scheduling the first visit, getting patients to arrive, helping them understand the plan, or scheduling the next step?

—Josh