In the United Kingdom, 'social proof' strategies help dentists keep more paitents

Want your patients to show up more? Give them a smiley face.

In the United Kingdom, no-shows for medical appointments were a significant and quite costly problem. A pilot study on social proof, or "herd mentality" as we sometimes call it, amazingly lowered no-show rates.¹ How can we implement this research into dental practices?

The following UK social proof systems made a difference:

• Patients making appointments were verbally asked to repeat the date and time for their next appointment before hanging up the phone. This costless change led to an immediate reduction of no-shows by 6.7%.
• Instead of the nurse or receptionist filling out the white appointment card, the patient was asked to fill it out themselves. This small change led to a further reduction of no-shows by 18%.
• Signs were placed in the reception area that stated, "95% of patients at (name of the office) turn up for their appointment or call in advance if they have to change their appointment." This strategy of social proof reduced no-shows by 31.4%.

A health economist for the National Health Service estimated these measures, employed across the UK, would be the equivalent to the cost of hiring an extra 472 physicians/year. What can you do with these same easy and costly approaches?

In my travels across the US and Canada, I see other forms of "social proof" employed. In the hotel industry, hotel rooms typically include messages about their concern for the earth and the environment. These comments, commonly displayed in the shower, bathroom, or the area where fresh towels are kept, include messages about the environmental benefits of reusing towels (which coincidentally decreases costs to the hotel).

Robert Cialdini, a professor of marketing and psychology at Arizona State University, took things further and informed guests that a majority of fellow lodgers had reused their towels at some point in their stay. These guests were then 26% more likely to reuse their towels. But when they were told that a majority of guests in their particular room had reused towels, the compliance rose to 33%.²

The bottom line is this: People want to follow the lead of what those around them are doing. That's social proof.

Another example: Opower sells software to electrical companies that compare customers' electrical use to others in the same type of household. Those that do better at conserving energy get a smiley face. In addition to social proof, it's key that people who do well are recognized. Motivated customers typically continue their efficient ways.

What can we take from this and apply to dentistry?

1. Ask your patients to confirm their appointments, either verbally, by text, or by email, of the date and time of their appointment. The most powerful method is verbal confirmation, but we know that patients today would rather click than call. The information above was reported in 2008. Times have changed, however—people would rather click than call. Perhaps a message could be included that states: "98% of patients in May kept their appointments as scheduled."

2. Ask your patient to fill out the appointment card time and date. However, patients today like the ability to upload the appointment into their calendar automatically. Instead of an appointment card, perhaps have the patient personally upload the appointment into their calendar and have them personally verify the date and time, once uploaded.

3. I can envision a digital picture frame in the reception area that says, "95% of our patients make their appointments.” Or, this message could be part of your reception area educational system.

Social proof can certainly be influential: Here are other ways to get your patient to keep their appointment.

- Begin by creating value on the phone and chair-side. On the phone, talk value before you talk about insurance or money. Talk about what other patients have experienced.

Social proof: "We have many patients who call and are worried about having dental treatment, just like you. What they've found is that our doctor is wonderful. She's kind and gentle, and will take the time to talk with you about your options. She'll review your x-rays with you, include you in the decision making process, and I know we can make the dentistry fit your time and budget."

- Chair-side, doctors, tell your patient "What's next and why." This method decreases confusion and increases case acceptance. An example: "Tim, next time you come in, we need to take care of the teeth on your lower right side. You need some fillings done because you have cavities. Also, the very back tooth has a large old silver filling, with a deep cavity and you've broken the inside wall of the tooth. Be very careful and chew on the other side. These teeth are fragile. It's best you get on my schedule within the next several weeks."

Social proof: "Many patients find it best to take care of these needs now, before the need for a root canal happens."

- Your hygienists should also create value—in the last 30 seconds. What's next for the patient, and why is it important to the patient?

Social proof: Even with squeaky clean patients, you can say, "Susan, one of the reasons you have great teeth is because you're so faithful in keeping your appointments. Like so many of our patients, you've made your oral health care a priority."

- Create value by training your team to talk from the digital x-rays and the intraoral camera, setting the stage for case acceptance. They'll open up your patient's ears, creating awareness about areas where you may be concerned. Auxiliary staff cannot diagnose, but they can set the stage by stating, "The doctor may be concerned . . .," or "The doctor may recommend . . ."

Social proof: 98% of our patients love seeing their teeth on the screen. It's great that you can see what we see; it's just like you getting to look over the doctor's shoulder."

- To increase patient loyalty and elevate case acceptance, I recommend doctors call their patients to check on your patient's progress following restorative or surgical care. 97% of the time, you'll be leaving a message.

Social proof: "Dan, I was calling to see how well you're doing. The vast majority of our patients do great following this care. If you have any concerns, though, don't hesitate calling me back. My cell number is . . ." Be certain to leave your personal cell phone number. This person will now refer many of their friends and you'll decrease future no-shows.

Your hygienist should also call any patient that had scaling and root planing within 48 hours of care.

Social proof: "Sara, I was calling to see how well you're doing; your last cleaning was a more comprehensive cleaning. The majority of our patients do very well, but if you have any concerns, don't hesitate calling the office."

How you say things and structure your systems in the practice does matter. Don't forget to recognize people who are doing well with their oral health and making their appointments. A positive approach utilizing social proof and positive feedback does matter to your patients!

¹http://www.theguardian.com/healthcare-network/2011/jul/28/nhs-bedfordshire-study-appointment-keeping

²http://www.influenceatwork.com/wp-content/uploads/2012/02/E_Brand_principles.pdf

Rhonda Savage, DDS, served as a Lieutenant Commander in the US Navy. Dr. Savage is the CEO of Miles Global. She’s a former dental assistant and front office staff and has been in private practice for 19 years and counting. She is the past president of the Washington State Dental Association and an affiliate faculty for the University of Washington School of Dentistry. She is a member of the Pierre Fauchard Academy, American College of Dentists, and the International College of Dentists. She is an author, consultant and speaker. She lectures and publishes on women’s health issues, leadership and management. For an amazing education system that creates value for your dentistry, contact her through www.SavageDentalMarketing.com.