Zuelke & Associates
Phone: 503.723.0200

As many of you know, my wife Betty has been an Orthodontic Case Acceptance and Marketing consultant for more than 20 years.  As a marketing consultant she has very often expressed her frustration with and concern for the large number of doctors who have hired her and other marketing consultants in the belief that the never-ending search for new patients is the solution to the goals of practice growth and profitability.  More than a few times I have heard her say, “If they would just fix their case acceptance problem and stop putting 35% to 45% of their new exams back into their communities having said “no” they would not need to be panicking about their new patient flow being inadequate.”

Every doctor, of any specialty, knows that new patients referred from existing patients have the very best case acceptance, typically 85% and better.  A practice generates patients from that source (existing patients) through appropriate internal marketing.  The next best case acceptance rate, typically 75%, comes from new patients who come to the practice as a result of quality community marketing.  Next in line, at about 60% case acceptance, are new patients coming as a result of doctor referrals.  Last on the list, with a case acceptance rate that varies between 30% and 50%, are new patients coming as a result of discount offers, coupons, direct mail, Internet, Yellow Page ads,  radio and television ads, and my personal favorite, billboards on the highway!

Those first three case acceptance numbers come to the practice as a result of quality marketing.  That “last on the list” case acceptance rate of 30%-50% comes from advertising!

However, all the quality marketing in the world will be wasted in an environment of poor case acceptance because a practice with poor case acceptance is, as Betty says, putting too many people back into the community, back to their dental offices’ hygiene programs, back to their neighborhoods, and back to their schools, having said “No!”  If you have been sending 35%+ of your exams back to where they came, there are simply too many patients out there who already have a negative experience of your practice.  The marketing you do that they experience, even that recommendation from an existing patient, falls on deaf  ears.  Put 40% or 50% of your new patients who said “no” to you back into the practices of your great referring doctors and it won’t be long before that great referring doctor starts handing out 2-3 business cards instead of just your own.

So, if you want your marketing efforts to generate great results you must first fix any problems with case acceptance.

Ten or so years ago, Betty did a detailed analysis of the group of her clients and our clients who all had enjoyed continuous case acceptance rates of 75% or better.  She turned that study into a list of policies, procedures, and other “traits” that were common to every practice in the study.  We have been handing out that list to our clients and seminar attendees since it was created.  I have presented that list here for your review, with a suggestion that the list be put on the agenda of your next staff meeting.

— Paul Zuelke

“For the past 20 years I have reviewed the systems and procedures in the practices that have consistently had the top Case Acceptance in the United States (75% or better)and  I am still continuing this research today.  I consistently see the following as the top 15 traits that are the most common and are areas that receive continual focus in these practices.” — Betty Zuelke, January 2015


15 Traits Common In Offices with Case Acceptance At 75% or Higher

1. The office has a happy, excited team, beginning with the Doctor – morale is great.

2. When a new patient calls to make their exam appointment they are educated that the exam is more than just a “quick look” and they are advised about the opportunity to get treatment started at the first visit.

3. The New Patient Exam visit is scheduled for a full 1 hour appointment and a new patient exam is always able to be scheduled within 7-10 days of the new patient phone call.

4. The Treatment Coordinator (TC) establishes a strong relationship with the new patient/family.

5. The TC discovers ALL of the patient’s concerns related to their teeth, their correction, and their budget.

6. The Doctor says the benefits of treatment and the importance of fixing the problem without leaving treatment optional or presenting treatment “options” for the patient to choose from.

7. The Doctor is in and out of the new patient exam in 15 minutes or less.

8. The Value and Benefits of orthodontic correction and the benefits of the office are consistently conveyed to all new patients so they know what we would worry about if their treatment does not take place.

9. A specific fee is quoted at the new patient exam visit.

10. There is a financial arrangement “speaking” process in place and being used properly.  The TC makes treatment sound easy and she makes the financial arrangement seem to fit the patient’s budget without sending the patient home with financial option sheets to think about.

11. Financial Arrangement and Informed Consent documents are signed at the new patient exam at least 50% of the time on patients diagnosed as being ready for treatment.

12. Records are taken the same day as the exam in most cases.

13. The office is able to get treatment started within 7 to 10 days of the new patient exam appointment so there is always plenty of room in the schedule for more starts.

14. Observation/Recall kids return every 6 months and feel a part of the practice (they leave the office with an actual appointment date and time scheduled to return – they do not feel they should just wait until age 13 to begin or that they will outgrow their orthodontic problems and/or needs).

15. Pending Follow-up patients are contacted by the TC within 2-3 days of the initial visit and the TC sticks with a proven follow-up process without giving up easily.

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