The True Cost of Lost Patients

James V. Anderson, DMD, Founder and CEO
James V. Anderson, DMD, Founder and CEO
eAssist Dental Solutions

Losing patients and losing customers has the same effect whether you are a dentist or a businessman. We ask ourselves why and what can we do to stop the loss?

In my business (eAssist Dental Solutions) and my practices, I began using a specific measurement of patient/customer satisfaction: the NPS Score (I first discussed this in my article The Ultimate KPI). Net Promoter Score®, or NPS®, measures customer experience and predicts business growth. This proven metric transformed the business world and now provides the core measurement for customer/patient experience management programs worldwide.

The NPS Calculation is a simple method to show who is a promoter of your practice and who is unhappy or not loyal. You can calculate your NPS using the answer to a key question on a 0-10 scale: How likely is it that you would recommend my dental practice to a friend, relative or colleague?
Respondents are grouped as follows:

• Promoters (score 9-10) are loyal enthusiasts who will keep buying and refer others, fueling growth.

• Passives (score 7-8) are satisfied but unenthusiastic customers who are vulnerable to competitive offerings.

• Detractors (score 0-6) are unhappy customers who can damage your brand and impede growth through negative word-of-mouth.

Subtracting the percentage of Detractors from the percentage of Promoters yields the Net Promoter Score, which can range from a low of -100 (if every customer is a Detractor) to a high of 100 (if every customer is a Promoter).

From the industry experts:
68% of customer defection takes place because customers feel poorly treated
95% of people who have a bad experience do not complain
13% tell up to 20 other people, while a satisfied customer tells only five other people
It can cost five times more to obtain new customers than retain existing ones

Make patient satisfaction your daily goal. Let’s face it – if you had a rough day at the practice, so did your patients. Issues arise due to scheduling mishaps, no communication with patients about insurance estimates, billing issues, misunderstandings about the appointment and what to expect, just to name a few.

When you lose a patient or customer, there is a lot at stake:

Lost patients = lost feedback to help you to improve. Asking patients with a survey about what you can do to improve your practice is seldom done in a dental practice. We ask for reviews of the current appointment on Google or other patient information sites, but is this enough? When we lose a patient, we lose the best of what we might learn to improve because it is too late. You lose their opinions, advice and criticism. Also, a lost patient is not likely to give the truth about why they are leaving. Identifying potential defectors before they leave can provide invaluable insight into where improvements can be made.

Lost patients means lost income. The cost of replacing this revenue is much higher than the cost of retaining the business. Keeping your patients happy is far less expensive than a marketing campaign to attract new patients.

Lost patients have an unfavorable impact on the confidence of the entire team. When a patient leaves for a reason that could have been prevented, there can be a demoralizing effect on the team. If the patient had a good relationship with others on the team, it can be a letdown to see this person leave.

Lost patients become an opportunity for the competition. You not only lose the patient, but the detractor gives the competitor information about their experience with your practice business processes and services, which leaves you vulnerable.

Lost patients lead to a disconnect from important business at hand. While your organization is crying over the loss of revenue, you may be distracted from other important business needs, such as seeking and retaining new patients.

Lost patients can be the beginning of a poor business reputation. You’ll become known for losing patients, which could derail your ability to attract and employ the best people. It can also smudge your image and reputation in the community. It depends on the industry and demographics to see how detrimental this can be. Dentistry is a small community, and word gets around quickly.

If you would like additional help, email Dr. Anderson at