Dentists use many methods to help attract new patients to the practice, retain existing patients, and convince patients to purchase services. Every management decision that dentists make in the practice has implications for patient generation. These efforts are marketing. External marketing looks at generating new patients for the practice, whereas internal marketing aims to retain existing patients. Both are necessary for a successful practice. The hours that dentists keep, the fees they charge, insurance plan participation, and the types of services that dentists do all affect patient generation and retention. Together, these are marketing efforts.

Depending on the competitiveness of the practice area, dentists will need to put more effort into marketing. If the practice is as busy as it wants to be (or busier) with the right kind and mix of patients, there is less need for marketing expenditures. Even practices that have a full complement of patients and do not advertise continue to market the practice through their communications and management of the office.

DEFINING MARKETING

Marketing is a managerial process that focuses a practice’s activities on the benefits sought by a target group of clients, thereby satisfying their needs and desires more effectively. Notice that marketing looks to satisfy the needs of a group of patients. The primary task is to learn clients’ needs, wants, and preferences, and then to develop services and products that satisfy those needs. This affects how dentists deliver their services and even how they organize the practice. It means listening to people and providing goods and services that they demand (or want). Marketing means that dentists view the practice through the patients’ eyes, thereby generating and retaining patients in the practice (at a profit).

It is as instructive to say what marketing is not as to start to define marketing. Marketing is not advertising, although advertising can be a part of marketing. Marketing is not the sales technique of a used car salesperson, although sales technique is a component of marketing. Marketing does not mean high‐pressure techniques, convincing people to buy what they do not need, or slick four‐color ads.

Marketing looks at dental consumers’ desires (not dentists’ professional assessment of their needs). Those desires fall into three broad categories:

• To avoid something, such as pain, disfigurement, noise, odors, x‐rays, or cost.
• To gain something, such as health, a pretty smile, or relief from pain.
• To prevent something, such as pain, disfigurement, or embarrassment.

Consumers do not want amalgams, composite restorations, partial dentures, or bridges. Instead, from their perspective, they are avoiding, gaining, or preventing something from happening to them. Dentists can provide a service that helps a patient achieve their goals. That service may be a prophylaxis, tooth whitening, or orthodontics. If it solves the patient’s wants, the dentist has acted with a marketing orientation. Part of the marketing orientation is to provide information to patients so that they know the available procedures and techniques. This education process makes consumers more aware of their needs, raising their level of wants and, therefore, their desire for dental services.

WHY DENTISTS MARKET

Dentists market to gain patients for the practice. Dentists have marketed their services since the first dental practice. In recent years, dental marketing has become much more sophisticated as dentists have brought business techniques to bear on professional practices. Several factors have fostered this.

The increased competition among dentists for the available patient pool has stimulated marketing. As described in Chapter 12, this is a question of the relative supply of practitioners and the relative demand for patients. Factors such as the number and age of dentists, auxiliary use patterns, technology, and practice patterns influence the supply of practitioners. The number of patients, usage patterns, disease patterns, third‐party reimbursement, and efficiency of preventive measures influence the demand for services. When dentists see gaps in their appointment book, they first try to encourage more patients to come to the office. In other words, they market their services.

Dentists have two kinds of competition. The first is to gain the potential patient’s attention and to have the patient patronize them instead of another nearby dentist. In this sense, dentists compete against each other for their share of the available patient pool. A dentist’s internal operational policies (such as the hours the office is open) and external marketing strategies (such as advertising campaigns) help attract new patients. Once the patient comes to the office, then the dentist faces a second, equally important marketing problem. That is to educate and convince the patient that their dental needs are important enough to spend (often large amounts of) money to meet. Because most dental procedures are discretionary in nature, dentists compete against other forms of discretionary spending for the consumer’s dollar. In this sense, dentists do not compete against other dentists but against travel agents, home remodelers, big‐screen television sales agents, and fine‐dining restaurants. Convincing the patient to come to a dentist involves external marketing plans. Once the patient is in the chair, internal marketing and sales techniques become more important.

The changing nature of third‐party contracts has encouraged many dentists to market their services. Various contract organizations (capitation plans and referral plans) may limit where patients can go for reimbursed dental care. Deciding whether to participate in one of these plans is a marketing decision because it addresses the patients’ desires for reimbursed dental care. Beyond that, a practitioner may see patients who sign up with a given plan leave the practice. The dentist then feels that they need to generate additional traditional fee‐for‐service patients to compensate for the managed care patients who have left. A practice’s insurance plan participation becomes one of its most critical marketing decisions.

The rise of consumerism and a revised legal and ethical climate in the profession have increased marketing in dentistry. In years past, the profession considered any advertising to be unethical. The American Dental Association (ADA) Code of Ethics and many state Dental Practice Acts described advertising as illegal. In 1977, a court decision (Bates and O’Steen v. Arizona) effectively ended professional prohibitions against advertising. This case stated that a professional must be allowed to advertise their services if the advertisements are not false or misleading. Simultaneously, consumerism was beginning to become an underlying trend in the United States. This trend advocates for more information for consumers to use while making informed decisions. According to this tenet, a consumer should differentiate among dentists. Dentists must tell the public how they are different from others. Some professionals have a problem with this notion. The public agrees with it.

Changing technologies have brought many new services to the arsenals of practicing dentists. These address consumer desires by fulfilling the benefits sought. Patients want to know about these services. Dentists who provide them want patients to know about them. Marketing answers both desires.

WHAT DENTISTS MARKET

Before a practice begins a marketing policy, the dentist needs to understand the characteristics of dental services to develop appropriate marketing strategies.

WHY CONSUMERS BUY

The consumer buys to satisfy their wants and needs. People want their purchases to solve a problem for them. In that sense, they buy benefits, not features of the good or service. The expected outcome is generally not simply to own the good or service but instead to use it for some end. Consumers do not really purchase aspirin; they purchase relief from a headache. If another product (acetaminophen or ibuprofen) offers a better benefit at a reasonable cost, they will purchase the other product. They do not care about how the producer makes the product or delivers the service. Box 23.1 summarizes these differences for implant services.

MARKETING PLAN DEVELOPMENT

When dentists are ready to begin marketing their practice, they must develop a marketing plan. Developing this plan makes the dentist look at the people they will serve to meet their needs. It also makes the dentist consider what they are doing well, what they need to improve, what competitors are doing, and how they will tell their story. It should fit with the dentist’s strategic plan and vision for the practice. The desired marketing outputs (e.g. additional new patients) are a function of these marketing inputs. The marketing plan consists of several discrete steps.

MARKETING STRATEGIES

Marketing strategies are the methods that dentists use to get their message to their target group. These efforts are grouped into two types, internal and external (Box 23.4). Internal efforts focus the attention on the existing patients of the practice, whereas external efforts focus on people who are not current patients.