Improve production, profitability, and your quality of life!


Paul Zuelke discusses how dentists can help patients to afford dental care

In many practices, the amount of treatment diagnosed that remains unscheduled is huge, often exceeding 6 months of normal production. Case acceptance in many offices is less than 40%, and the national average is lower than 60%! That is a lower rate of case acceptance than what the profession had 30 years ago, but many dentists have accepted today’s rate as “the norm” and believe that their only path to growth is more new patients.

A never-ending search for new patients is rarely the solution to greater production or to greater profitability. In fact, many choices doctors make to build new patient flow (joining PPOs, large Yellow Pages’ advertising, direct mail advertising) actually cause grave damage to practice profitability. Instead, the answer is to increase the percentage of diagnosed work that your patients schedule. Note that I did not say “accept.” Every month, dentists see thousands of dollars of “accepted” diagnoses go out the door, never to actually be scheduled and completed.

The responsibility of the dentist is to make it easy for his/her customers (patients) to buy the product (dental care/implants) that he/she sells (diagnoses). Far too many doctors have forgotten that 80% of patients/parents cannot afford to write a check for $3,000, $5,000, or more. Consider the rock solid blue-collar family with five kids who just had to fix the transmission in their car? Can they even afford today to write you a check for $800? All too often, the answer is, “No.” Those patients may well “accept” your diagnosis, but they will fail to actually schedule the treatment. Case acceptance has declined not because of the economy nearly as much as because of dental practices’ aggressive financial policies, the insistence on payment in full, and the almost futile efforts to push patients into outside financing!

My advice to our 1000+ dental clients since 1980 has been to be flexible with respect to financial arrangements. If $0 down payment and 4-month, 6-month, or even longer financing is necessary in order to get a patient to accept the entire diagnosis, and if the responsible party is creditworthy, then grant that type of in-office credit to your patients! Are you really willing to lose a $5000+ case because your patient/parent cannot afford to pay you in full, or cannot afford the 50% down payment you are asking for, or chooses not to use outside financing?

Notice the key phrase above is “if the patient is creditworthy.” There is nothing worse for the quality of life within a practice than to get into a financial relationship with a financially weak patient. Missed appointments, poor clinical cooperation, zero referrals, etc., are always the result. While it makes sense to be financially liberal with quality patients, it is a major mistake to do so with patients/parents who are immature, unstable, and/or unwilling to, or incapable of, keeping their financial agreements.

Fortunately, with modern elec-tronics, in less than 60 seconds, a practice can make a high quality credit decision identifying the potential financial risk of any given patient. What is it worth to you to know that your patient/parent has, for his entire life, paid all of his/her bills? Conversely, what is it worth to you to know that this person never meets his financial obligations?

Seventy-five percent of most practices’ new patients are in the low to zero financial risk category, what we call “A” patients. Twenty-five percent are in the moderate to high risk category, “B” and “C” patients. Grant credit proportional to that risk, and you will improve your production, your profitability, and your quality of life within the practice.

Various products are available to help you assess risk as described above. Consider the Zuelke Automated Credit Coach (ZACC), a web-based tool specifically designed for the dental profession, which evaluates patient maturity and stability, obtains and evaluates a credit report, and returns a credit “grade” and a payment plan recommendation in seconds. ZACC evaluates credit risk in exactly the same fashion as does a bank loan officer but does not affect your patient’s credit score. To learn more about ZACC, take a look at or email

zuelke_headshotPaul Zuelke is president and founder of Zuelke & Associates, Inc., a management consulting firm specializing exclusively in teaching credit management and accounts receivable control techniques to health care practices.  Mr. Zuelke’s extensive, professional background in lending and corporate finance, combined with over 30 years of experience with over 1,000 client practices located throughout the United States, Canada, and Australia, position him as a leading authority in using effective credit management to build a quality health care practice.

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