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“Are you a Patient of Record?” – Converting Emergency Patients Into New Patients by Rhonda R. Savage, DDS

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Emergency patients can be practice builders: more revenues, more referrals and, if handled well, more new patients. There are two types of emergency patients – new patients and existing patients. Both want empathy, a knowledgeable dental team, reassurance and they want it right now!

Why accommodate and appreciate emergencies? It depends on your need for new patients. What are the parameters that you need to consider for the future of your practice? Are you looking to transition, bring in an associate, partnership or sale? If not, do you have the patient base you need?

If your practice is located in a transient area, look at your active patient count as those who have been in for an appointment during the last 18 months. Stable areas can determine active patient count for the last 24 months. (You might need to call your software management company to put parameters into the system to get an accurate count.)

Most general dentists need 1,500 to 1,800 active patients for a full-time practice. If you provide more definitive dentistry, you might need more new patients who are willing to accept the dental care you offer. For most practices, in order to maintain your patient base, you need 10 to 20 new patients a month per doctor. If you have a need to grow your practice, you need 25 to 40 new patients a month per doctor.

Why would you need at least 10 new patients to maintain your base? Because some will leave due to insurance changes, others will go away for school; some will follow their spouse to the dentist he or she uses. And sadly, some die. However, most will leave because of a perception of a lack of customer service. If your practice receives less than 10 new patients per month, your practice is declining.

Emergency patients can build your patient base, if your team can convert them into a new patient and you earn the patient’s trust. How do you earn trust? Honesty plus integrity leads to trust. The honesty part is pretty clear to most of us. But what does integrity mean?

Integrity means you follow through; do as you say you’ll do and very importantly, you respect the patient’s time. You diagnose with the patient’s best interest in mind. Integrity means you train yourself and your team. Integrity means you’re competent. Integrity is one of those things that your patients will sense and feel; it’s harder to define than honesty.

In order to gain trust, your team has to be competently trained to handle the emergency patient. In order to gain competency at any skill you must practice. The same goes for treating emergency patients. Verbal skills, customer service and great clinical skills come from practice. Converting the emergency patient into a new patient begins on the phone, and your team needs great phone skills. I’ll mention a few tips in here regarding the phone, but you can also refer to the Dentaltown Magazine Archives to read my article: “Your Phones: A Joy or an Ouch?”

Verbal Skills
Let’s go back to the title of this article, “Are You a Patient of Record?” Many times, people call and say, “Hi, this is Sarah Stevens. I have a tooth bothering me and I need to see when I can get in.” If you have a newer front desk person, he or she might not recognize Sarah’s name. The patient can be insulted if the team member says, “I can help you with that. Are you a patient of record?” Change this to say, “Certainly. When was the last time you saw the doctor?” The patient will either respond with, “Oh, I haven’t been in before” or “I was in about a year ago.” Now you know whether you have a new patient or an existing patient.

Essential Phone Skills
  • All of your front desk team needs to be friendly and happy when answering the phone.
  • They need to be knowledgeable.
  • They need to express empathy by asking concerned questions.
  • Be certain to “talk up” the doctor(s).
  • Make sure they find out how the patient learned about your practice.
  • Staff should begin by saying his or her own name: “Thank you for calling Dr. Savage’s office. This is Kathy. How can I help you?”
  • Staff should ask for the patient’s name if it’s not immediately offered.
  • Staff should use the patient’s first name throughout the phone call.

How to Deal with Insurance Questions
If you’re not a participating provider or you’re not in network, don’t say, “We’re not in network” or “We’re not a Preferred Provider.”

Instead say, “We’re not a contracted provider for your particular plan, but we do have a lot of patients who come here with your plan. They come because of the quality of care our doctors give our patients. You’ve chosen the right place to call. Our doctors believe in doing it right, not doing it over! You’ll need to bring $100 with you to cover your deductible and your noninsurance balance. Will that be OK for you?”

How to Deal with Money Questions
If they need to bring money, let them know and tell them how much, but be tactful. Ask, “Will that be OK for you?” If you don’t ask, the patient might schedule but not show up. By asking, it gives the patient the “out” clause. They can say “no” without embarrassment.

Some practices, on the first visit, will not tell the patient about the difference in coverage, and instead, will only charge the amount that the patient would incur if they were seeing a participating provider. They want to get the patient in the door so the patient can experience the practice. However, this can be perceived as a bait-and-switch philosophy. You can anger the patient. It signals lack of honesty and lack of integrity. You’ll create underlying resentment even if the patient continues with you. The relationship starts off on the wrong foot. I believe it’s best to be honest and up front with the potential patient about participation or non-participation.

How to Deal with Scheduling
Build flexible time into the schedule to predictably accommodate emergencies. If you get three emergency patients on average a day, build in at least two time slots. These should be 30 minutes for triage: X-ray, exam and prescriptions, unless there is time to treat. The slots can be filled with restorative the day of if you don’t need all the slots.

The emergency patient should only be treated if you do not keep an existing patient waiting. Also, make sure your team makes firm financial arrangements at the chair – pay at the time of service, use a third-party financing service or write a check. There are exceptions, of course, for trauma or emergency.

Your emergency flex-time should be mid-morning or mid-afternoon (or your slowest time of day). Offer the patient two options. About 75 percent of patients will take what you offer them. The remaining might need early morning or later afternoon. The worst time to schedule the emergency patient is just before lunch or in the last 45 minutes of the day. Flexible time can also be pinpointed at the morning huddle, due to changes in the schedule based upon phone messages.

Inviting the Emergency Patient to Become a New Patient
The best time to invite is when the patient is on the phone. The patient benefits tremendously if he or she choose a full exam versus an emergency exam.

An emergency new patient or an overdue existing patient calls with a toothache: The ability to diagnose is determined by the available X-rays and the doctor’s time and focus. What if there’s a lot of other decay that’s not visible without a full set of X-rays? The patient might choose treatment differently if he or she knows about the other extensive needs. Also, if the patient needs an oral surgery referral, a limited exam and X-rays might not address the other oral surgery needs. You can save the patient time and money if the full diagnosis is done.

Of course, this depends on the schedule and staffing, as well as the patient’s willingness and financial ability. But if the patient has dental benefits, the full exam and X-rays will most likely be covered at nearly 100 percent. Make the suggestion on the phone and try to convert if you have the time in your schedule.

Converting the Emergency Patient into a New Patient
Offer to do a full exam/X-rays when the patient is in the chair, if you have time and the patient was interested during the phone call. If the patient isn’t interested, don’t try to talk the patient into coming back and scheduling for a new patient exam. Instead, say to the patient:

“Sarah, you do have a lot of dental needs. When you’re ready, we can get you back for a new patient exam. You’d get necessary X-rays and then we’d sit and talk about your options. The good news is you do have options! It’s a good thing to do. Emergency dentistry can be painful and expensive; preventive dentistry isn’t. We can make your treatment fit your budget, your needs and your schedule. So when you’re ready, give Kathy a call and she’ll get you scheduled.”

Notice the “You-You-You” focus It’s all about the patient.

Also, about 50 percent of the time, the patient will say, “Well, can’t I schedule that now?” Now it’s the patient’s idea, not yours! You’ll have a higher show rate for this patient; you’ll have a higher “no-show” rate if you try to talk her into scheduling a new patient exam.

Conclusion
Emergency patients can build your practice. Patients are postponing treatment due to finances more now than ever before! Focus on verbal skills, timeliness, attention to customer service and you’ll have more profit, more referrals and more new patients!

Author Bio
Rhonda Savage, DDS, a former dental assistant and front office staff, graduated with a B.S. in Biology, Cum Laude, Seattle University in 1985. She then graduated from the University of Washington, School of Dentistry in 1989, with numerous honors. She served on active duty as a dental officer in the U.S. Navy during Desert Shield/Desert Storm; awarded the Navy Achievement Medal, the National Defense Medal and an Expert Pistol Medal. Dr. Savage was in private practice for 16 years. She has authored many peer reviewed articles and has lectured internationally. She is a past president of the Washington State Dental Association and is an affiliate faculty member of the University of Washington, School of Dentistry. Dr. Savage is the CEO for Miles Global, an internationally known consulting business. A member of the National Speakers Association and the Institute of Management Consultants, Dr. Savage is a noted speaker on practice management, women’s health issues and zoo dentistry. To speak with Dr. Savage about your practice concerns or to schedule her to speak at your dental society or study club, please e-mail rhonda@milesglobal.net, or call 877-343-0909.
Dentaltown Magazine
September 2025
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