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Ontario Dentist - June 2000

Why Do Patients Return To A Practice After the Owner Retires?

by Timothy A. Brown, A.L.A.

"When I leave this practice, many of my patients will not stay with the new dentist." "When I purchase this practice, I will lose a large percentage of the patients." I hear these two statements all the time. But they are both total misconceptions.

Each time I arrange for the sale of a dental practice, I patiently listen to a dentist or dentists trying to convince me that one of these statements will come true. Patient retention, and how it will impact the practice after the closing date of a sale, is a legitimate concern. Yet, in reality, it is an insignificant issue for negotiating the sale price of a practice.

Dentists who are selling their practice often believe that many of their patients will seek treatment elsewhere once they are notified that their dentist is no longer available to treat them. Vendors do not want to see a purchaser fail due to substantial patient loss. Conversely, dentists who are buying a practice often believe that patients will leave as a result of the change and that they will encounter financial difficulties. This is an issue upon which a great deal of emotion is often spent for little reason.

To understand the issue better it is wise to consider why a patient goes to a particular dental practice. Why do they return for treatment time and again? What are they most likely to decide if their dentist retires? Why do so many patients choose to stay with a practice after their dentist has departed?

I believe their are five main reasons:

The Dentist - Patients form a bond based on trust with their dentist. It is precisely this trust that causes them to return to the practice after you leave. Simply put - your patients follow your advice. Provided you send out a letter of introduction that encourages them to visit the new dentist, they will rely upon their trust in you and follow your advice. This first reason patients will return to your practice once you have gone is the most powerful of all. If I trust you and you suggest I visit the new dentist, it's very likely I will.
The Staff - I have formed a relationship with the receptionists, assistants and hygienists at the practice I attend. I say this with all due respect to my dentist, ODA member Rosanna Woroshyl, but if she were to sell her practice, I would go back there in part for the friendships I have with these wonderful people. I recognize their names when they call to remind me of my appointments, they know where and when to call me and I look forward to seeing them each time I visit.
Location - I also go to the practice because of its location. I shop in the area. My home and office are nearby. If the owner were to sell, I would continue as a patient there because of the convenient location alone. As well, I am familiar with the parking, the decor and the equipment - and it's been proven that patients appreciate a familiar environment when it comes to dental offices.
Policies - At the practice I go to, I know exactly what to expect in terms of the fees, method of payment accepted and what my obligations are if I must cancel or change an appointment. Patients like the comfort of knowing the policies before going to any dental office.
Habit - Even if my dentist sold her practice tomorrow, the fact that I, like most people, am a creature of habit and do not like change would bring me back to the same office. Most people will have to change dentists at least once or twice in their lifetime whether they want to or not - and more often than not we don't want to unless absolutely necessary. Changing dentists is often a new and foreign experience, involving filling out new medical forms, meeting new faces, finding an office where you feel comfortable and generally accepting a multitude of new information.

Even if one of these five reasons for returning to the same dental office is altered - the dentist's departure, for example - the other four reasons remain. And that's why the majority of patients return even after the previous dentist has gone. Even in the event of the sudden death or disability of the dentist, patient retention tends to be very high. In fact, I have documented patient retention in hundreds of transactions and purchaser surveys and 85 to 95 per cent of the patients continue to attend the same practice after a sale.

Another thing that I have discovered is that the previous owner does not need to stay for a transition period to ensure patient retention. Practice purchasers often tell me that this is a highly overrated concept. In fact, in most instances, they say that they are ready, willing and able to handle the practice on their own much sooner than expected.

Today, in roughly half the transactions I arrange, the previous owner leaves immediately upon closing. The only transition is a well thought letter of introduction and some other minor planning. Sometimes, this is preferable as it allows for a clean break and no conflicting issues for staff and patients. I am a strong supporter of this exit strategy for my clients.

There are exceptions, however. Patient loss may be experienced when the new owner makes too many changes too quickly, inadvertently frightening patients away. While studying these cases, I found a common denominator: drastic alterations were made to the practice. Patients do not appreciate the modernization of "their" dental office. They have been going there longer than the "new" dentist has been there and they have expectations. In these cases, the buyer neglected to consider the human element of people's resistance to change. Patients do not welcome change with the same enthusiasm as the new dentist may.

But, rest assured, in most instances, unless great changes are made that disassociate the patients with the previous dentist too quickly, patient retention is very high in most dental practice sales.

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