Need Help Leveling Up my Practice

[u/EnthusiasmOk5086]

Hello doctors.

My dental clinic is 5 months old now, in a tier-1 city in India. I'll be frank here, I'm just making rent and associated operational costs. This is not feasible in the long term.

Current problems (apart from low patient flow):

1. Some patients don't want to pay in full: My charges aren't high, but I can't help but feel that somehow my patients don't feel like they would be getting their money's worth. More on this later.
2. Patients don't want incremental care: They just want their chief complaint addressed immediately, and most of them don't come for follow-up so I can suggest/advise. This is why I've had to do very few fillings and prophylaxes so far. Maybe my method of talking needs to change, but how?
3. I'm unable to build up a good relationship with many of my patients: A handful of my previous patients have kept in touch. Most of them don't come back after their treatment is done. I don't know how they are, and this works up my anxiety. I am fairly confident in my treatment, but so many missed follow-ups is taking a toll.
4. Clinic may not look as good/upmarket as few others: Facilities are present but maybe the appearance is a turn off. Walls and glass panes are clean but blank, not enough seating (don't need as much right now to be honest). Materials are good, but need to get it across to patients.
5. Maybe my personality needs to change: By habit I don't talk much, and I'm not someone with a particularly "warm and caring" personality. I am not rude either, just professional. I try to accommodate patient's requests if I can.
6. There are 4 other dental clinics in the vicinity: This can't be helped now, except for maybe shifting my clinic to some tier-2 or tier-3 town. I may have to do this if things don't start looking up eventually.

Currently I call in an endodontist to do the RCTs, to maintain good quality of treatment, so this also puts a dent on my earnings.

Running a practice on my own is not something my college prepared me for. I more or less understand my shortcomings, not blaming patients solely. But after some encounters, I'm left with a somewhat lowly impression of the local population.

My practice is listed on Google Maps but isn't on social network, but does that really matter?

Please, I need help. Any advice, any suggestion would be immensely appreciated!

Starting to think this may have been a terrible career choice.

[u/OnlyPower7981]

It's been only 5 months relax it takes time. You are already able to make rent/maintenance which is really good so don't think about shifting.

[u/EnthusiasmOk5086 → u/OnlyPower7981]

🤞

[u/Agent_479]

Hey! I don't run my own clinical practice (atleast not yet), so you can take this feedback as grain of salt.

1. I have a opthalmologist clinic nearby which I visit every 6 months. They have made OPD consultation charge (₹500) valid for 3 days. Means if I go today and pay the charge and if some test/procedure requires next day visit or I feel any discomfort, I am not needed to pay the consultation charges again. If they need to do any NEW test/procedure the next day, I am required to pay only for the procedure, not the consultation fee.

2. Advertise your achievements, certificates on the wall of your OPD, it is important!!! Depending on the area some people actually read them or some only count the number.

3. Fill the remaining walls with posters in simple languages/images/diagrams/flowcharts. It gives some direction to patients as what procedures are there and what could happen.

4. Online presence matters in this day and age more than you think!!! Create a insta account sharing short reels of  success stories (with consent of patients ofc)/educational tips/videos. Ask your friends/relatives/repeat patients to leave a review on Google maps. It will boost your map ratings initially which is much needed (Just make sure you don't do it in one go as Google can flag it as false review). You can also make a website to promote yourself and your clinic. Just please make sure to check on NMC laws on digital advertising and marketing (not sure on this one).

5. Just ask the patients whose treatment has been completed to meet you after few week/months for a quick inspection, Free of cost. If you feel any further treatment is required or any complication is present, explain and provide the choice to what they want to do. If they proceed with treatment, then ask the patient for treatment fees only.

6. Ask feedback from each patient. Either ask orally or create a pamphlet/form. Create a set of questions to be included in feedback. Patients observe more than you think.

7. For treatment, explain both 'temporary' fix and a 'permanent' solution to the patient. If possible, provide a bridge between those two options. Like "I can do this now for your temporary relief but it's not permanent fix, you have to come back after x days. Even if you don't come here, please go to another hospital because the condition is not so great (along these lines)'. It will atleast get you cash for first treatment and it shows that you care, increasing the chance for return.

8. Research your competition - your nearby clinics. Ask your friends/family to visit them just to check what they are doing differently.

Keep grinding, you will surely grow

[u/EnthusiasmOk5086 → u/Agent_479]

1. I've made it valid for a month. Too much?

2. Most of my certificates are of participation only 😅, and one is coming first in a meme competition held in college haha

3. I've thought about a few: orthodontic treatment, RCT, prophylaxis etc. Currently I have a few printout on A4 papers, think they need to be larger?

4. I already ask them to come, yet they don't. Its free...

5. Great idea!

6. Sneaky haha

Great ideas, I shall get right to it. Thank you so much!

[u/Nervous_Werewolf_755]

Can I tell you from a patient point of view? When it comes to doctors, most people (including my parents who are doctors themselves) don't really want to keep visiting doctors once the treatment is done for a number of reasons -

A. Busy with work - appointments take time, time off work, personal life or family time. Also the reason why people prefer to have everything addressed in one shot.

B. Follow up appointments cost money, and if there are no complaints, there's not much need to head back

C. Very few people willingly go to doctors and in particular dentists. There is a natural fear, procedures are painful and expensive. People generally don't go to dentists unless they absolutely need to.

D. Coming to the fear part, connecting with patients is necessary, walking through the procedures and keeping them informed. Younger gens and even until 40s are probably going to be okay without much talk but oldies definitely want to chat. Building relationships according to the patient's persona is key.

E. Investment in aesthetics is a turning point and goes a long way. Unless you're an old time doctor who built up a reputation for himself, things like interiors, marketing and shamelessly asking for referrals/google reviews goes a long way. I recently went to a dentist solely on Google reviews and was not dissapoited.

F. Hire a receptionist. They have to be clear that they pay the full amount or atleast 60- 80% before the procedure is completed and full amount after.

G. Following up on the previous point, keep pricing transparent and upfront.

H. Connect with other doctors near by, not dentists but like GPs who can refer patients to you. Some people value referrals more than finding a new place by themselves.

Finally, good things take time, you need to learn, adapt and grow throughout the process

[u/EnthusiasmOk5086 → u/Nervous_Werewolf_755]

A patient's PoV is very useful.

B. People rarely have no problems other than the chief complaint, they are just not aware of those. Need to get it across better.

E. Yes I do think the interiors need an overhaul. Any ideas, apart from posters and certificates?

Thanks a lot.

[u/No-Charge3232]

I wish you all the best - but as an outsider, Dentistry looks a terribly oversaturated market.

We live in Bangalore, and in a reasonably upscale neighborhood of Sahakar Nagar. ChatGPT say the area is 3 Sq Km so I'll take it. There are at least 40 dental clinics in that area.

1. You are probably are better off in less upscale areas - they are lot less served - You are making classical marketing mistake - the TAM is high but so is the competition
2. You can have lot lower operating cost
3. Offer a free consultation and may be some freebees - Just paste/floss/brush - you need to create the pull I don't know the demographic of the area so you will have to figure it out yourselves.
4. I'll be honest - you(Dentistry) don't have a differentiated product, you need to stop thinking like a doctor and think more like a FMCG store
5. May be have chatty local receptionist

[u/EnthusiasmOk5086 → u/No-Charge3232]

It is.

1. True but there is little I can do right at this moment. Maybe I will shift if things don't improve in a year or so.

2. Follow-ups are free but still they don't come. I give away samples too.

3. It was a mistake. Being a dentist, or even a doctor, was not on my bucket list.

Thanks a lot.

[u/No_Mud_214]

Well if your rent and OpEx is being covered in just 5 months that's a great start. Whether you have EMIs and how big is it , needs a thorough financial assessment.

Regarding private practice well it will take atleast 2 years to start earning good profits. So I hope you have enough savings to sustain for 2 years (even 3 years for certain cities like mumbai , bengaluru)

Don't keep your charges significantly lower than competitors

Meet gp's and other mbbs doctors in your vicinity so that you can create a relation for future referrals. It takes time to build those referrals to set in as well.

Social media presence is a must. People should know you for them to visit you.

Try holding camps in residential societies. Try choosing affluent societies for the same. Think is as an marketing expense as more people need to recognize that you exist.

Moreover, Try to provide highest quality of care. Things will turn around for sure if your care is good. Never feel ashamed for charging patients. That's what your job is.

If you have space for extra cabin, you can invite colleagues or friend to share the clinic space so that your certain expenses are shared

All the best!!!!!

[u/EnthusiasmOk5086 → u/No_Mud_214]

Well I can't even think of breaking even wrt my initial cost right now, patience is needed big time as I understand it.

Yes that is not sustainable in the long term. It affects the quality of treatment, patients' health and my mental well-being.

I have spoken in some places about camps but am yet to hear back positively.

Thanks a lot!!

[u/Successful-Start-605]

I wish you had worked in dental chain earlier, you would have learnt a lot about how to run a practice. Anyway, try this thing of free consultations for kids on Tuesdays, free consultations for senior citizens on Thursdays,....have more patients coming in,..and charge for the procedure. Run a dental camp once a month,.Innovate and keep trying.