The #1 Reason Why Your Dental Referrals Are Drying Up

Up until I started dental school in 1996 (yes I’m old), I had NEVER carried any type of debt. Owning a lawn care service in high school and college helped me to always keep money in my pocket and to steer clear of credit cards. I distinctly remember one weekend pulling up to an ATM with my friends in high school. Not knowing what an ATM was at the time, I was amazed that they could put a card into a machine that fed them cash (without having to do any work!)

I asked my friend Mike, “Where does all of that money come from?” He answered, “My dad puts it in there for me.” Wow! Talk about teaching your kids about handling money!

My parents worked hard and put me through school up until college. My dad informed me that anything I decided to pursue past college, I was on my own to foot the bill. Because I wanted to go to dental school I had to succumb to my first taste of debt.  Unfortunately at that time Sallie Mae entered my life.

After four years of dental school, a one year GPR residency and three years of perio training, I had racked up $250K+ in student loan debt. Couple that with the fact that my job fell through shortly before graduation, I was ready to get rid of the my debt no matter what it took.

Fast forward to the present. I feel so passionately about everyone becoming debt free, I recently started a blog, about it.

I’d love for you to check it out here.


It’s amazing to see how many people are walking around carrying tremendous loads of debt. But for us and others that sell products and services, it makes our life so much easier than if it didn’t exist. How many of your patients could REALLY afford your treatment if they weren’t able to finance it? Think about that.

Honestly, do you really think dental school tuition would cost hundreds of thousands of dollars if student loans weren’t readily available?

Do you think that that new Chevy Suburban would have a price tag of $70K+ if E-Z financing from the dealership wasn’t possible?

I don’t think so.

Student Loan Debt Statistics

For most of us, debt has been promoted and embraced as a perfectly normal part of life. I remember listening to Dave Ramsey on the radio over twenty years ago telling a caller that he shouldn’t buy a new vehicle ($3oK) because he couldn’t pay cash for it. The person couldn’t wrap his brain around the fact that more than likely, he would NEVER be able to drive a new vehicle using the “Dave Ramsey” method. His income wasn’t high enough but “everybody” was getting car loans and he “deserved” a new car. Yeah, right.

If you don’t believe that debt is considered the “norm” here in the U.S., then here’s a few fun facts for you:

  • 8.8 trillion in home mortgages
  • 1.3 trillion in student loans
  • 1.2 trillion in auto loans
  • 931 billion credit cards (what’s in your wallet?)

These numbers continue to rise each day and disturbingly most folks don’t see this as a problem.

The #1 Reason Why Our Referrals Are Drying Up

Now that hopefully I’ve gotten your attention, let’s shift gears a bit and talk about our practices. Why are our referrals going away from dentists? You guessed it…DEBT.

In Dale Carnegie’s fantastic book, How To Win Friends & Influence People, he talks about putting yourself in the “other person’s position.” Why don’t we do that for a moment.

Let’s put ourselves in the shoes of a general dentist.

Here’s what they are dealing with:

  • Student loan average of over $300K
  • Notice that most of their GP friends are placing implants, treating ortho cases, doing molar root canals, etc
  • Are visited by dental reps monthly (ex: implant and Invisalign)
  • Notice most dental meetings discuss/teach specialty procedures to GPs

*As a side note, I spoke with a periodontist yesterday on the phone. He told me that he recently fired his long time dental implant rep due to the fact that he was soliciting his “referring docs” behind his back to see if they wanted to learn how to place implants.

Folks, this is what we are up against and will CONTINUE facing even more in the future.

BOTTOM LINE: Most of our referrals are going away due to…DEBT. That’s right. Student loan debt. Specifically the debt that your local dentists have. Most has to do with student loan debt but also worsens when you factor in their other debts such as practice loans and consumer debt. Unless you start a loan hardship program, this problem ain’t going away anytime soon.

What’s Next?

Now that we know the “WHY” the referrals are shriveling up, what now? How can we position ourselves where we are NOT relying 100% on others for patients? Look, I’m from Louisiana and I like to keep things Simple with a capital “S.” So for my practice and many of my clients, there are 2 Main areas to focus on for now:

  • Attraction (patient)
  • Conversion

That’s it. Pretty simple, eh?

You’ve got to have multiple streams of patient flow through your practice’s pipeline + (don’t miss this part) your team has to know how to CONVERT them. What’s the point of paying someone thousands of dollars each month to get your phones to ring and your team has no clue how to deal with them to get them appointed? What a waste of dough.

What’s Your Conversion Rate?

Roughly two years ago, David Herman, founder of contacted me. His company primarily helps dentists get patients for the internet. He has no problem doing that for dentists, but the main problem he has is out of his control. It’s the dentist’s conversion rate.

He informed me that most of his dental clients converted >30% of the leads that were calling their offices for potential appointments. He noticed that our conversion rate was over 90% and actually hired me to train his client’s staff members! I was truly humbled by this opportunity that I decided to do this for specialists as well.

Look, it’s really not that hard to put together a marketing campaign to get people interested in your services. Think about it…if I put a billboard up in your town that said, “FREE DENTAL IMPLANTS Call xxx-xxx-xxxx” your phone would ring off the hook right? Many of these marketing companies claim they can get you 100+ patients a month running these types of campaigns but realistically you’re not going to be able to convert many.

Get More Patients from the Web

From my experience of marketing online for some three years now, we convert on average 18-20+ patients per month (from previously 6-8 per year). It took 6-7 months of listening to recorded calls daily + role playing to get to that point. It wasn’t easy. So my advice would be to get your affairs in order (team training) BEFORE you ramp up your marketing.

We recently began doing BOTH online marketing and a team training combo for a FANTASTIC periodontist, Dr. John DiGirolamo ( He contacted me one day after noticing over 95% of his patients were coming from local dentists. He also started to notice that more and more of the dentists in his area were either placing their own implants OR bringing in other docs that were aggressively doing so.

If you are interested in learning more about how to begin BOTH acquiring patients from the web + a done-for-you team training?

Email me at

How about you? What’s your current referral status like?

Comment below! 


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