Recommendations to Effectively Schedule Patients with Uncompleted Treatment Plans

Gary Takacs: This is The Thriving Dentist Show with Gary Takacs, where we help you develop your ideal dental practice — one that provides personal, professional, and financial satisfaction.

Gary Takacs: Welcome to another episode of The Thriving Dentist Show. I’m Gary Takacs, the Thriving Dentist Show founder and co-host, and we have a great episode to share with you today. This episode is titled, Recommendations to Effectively Schedule Patients With Uncompleted Treatment Plans. I know this is an episode that all of you will get lots of useful information you can apply in your practice.

Before we get to this episode, two quick announcements to make. The first announcement — exciting for me to share with you — is that coming up shortly after publishing this episode is a Thriving Dentist Virtual Summit. And this summit is happening on Tuesday, March 24th, from 6:00 to 9:00 PM Eastern Time. So go ahead and do the time translation for yourself — 6:00 to 9:00 PM Eastern Time, three hours. And the summit is titled Stress-Free Dentistry 2026, with a subtitle: Balance Growth and Performance.

Gary Takacs: So if you’re interested in stress-free dentistry where you balance growth and performance, that Thriving Dentist Virtual Summit will be a great one for you to attend. I’ll be doing a keynote presentation to open that virtual summit. And then we’re going to have panels of experts that will share their thoughts around how to reduce stress in dentistry, and how to balance growth and performance and reduce stress at the same time.

We have some great panelists that’ll be joining us for that. But go to thrivingdentist.com/events. There’ll be three hours of CE for you to attend for that course — at no tuition. The events that we put on virtually have no tuition, so no tuition for you. The best value in dentistry, if I must say so myself.

Gary Takacs: But you do have to register for it. So go to thrivingdentist.com/events and grab your seat and come join us on Tuesday, March 24th, 6:00 to 9:00 PM Eastern, for our next Thriving Dentist Summit. Look forward to seeing you there.

The second announcement I have is we have a marketing tip with my co-host, Raja. He’s our resident marketing expert on The Thriving Dentist Show, and he’s going to share with you what are common mistakes team members make when answering the phone. A very important part of successful marketing is how we answer that phone for incoming potential new patients.

No further ado — here’s Naren with a Thriving Dentist marketing tip: What are common mistakes team members make when answering the phone?

Naren Arulrajah: Hello, everyone. I’m Naren, the co-host of the Thriving Dentist Podcast, and in today’s marketing tip, I’ll be talking about the common mistakes team members make when answering phone calls.

So, the biggest mistake team members make when answering phone calls is mindset — like how they see themselves, how they see their roles. A lot of people who are answering phone calls were hired to be receptionists, and historically, a receptionist meant your job is to answer questions, be helpful. But unfortunately, when it comes to answering calls from new patients, that mindset can be the biggest weakness. You are not here to answer questions — rather, you are here to take control of the call, and you are here to get that patient to book an appointment.

So you are the Chief Impressions Officer. You are the Chief Booking Officer. So change the mindset of your team members. Ideally, even hire team members who have that mindset — who are looking at seeing themselves as the Chief Impressions Officer and the Chief Patient Booking Officer.

Naren Arulrajah: So that’s number one — work on the mindset, because until you work on the mindset, nothing else will change.

Second mistake I see team members making is they don’t take control of the calls. A lot of times, the patient is leading, and they’re answering questions. Again, in most of life, if you don’t take control of a situation, you won’t get the outcome that you desire. So taking control of the situation is a really, really important next step that team members need to master.

For example, it’s as simple as asking patients about what made them call the office. That’ll get to the root cause. In other words, perhaps a wedding is coming up and they want a beautiful smile. Or they had a wonderful dentist and now they’ve moved to a new town, and they’re looking for that same experience.

Naren Arulrajah: So you can find out what that "wonderful dentist" means, and really go to the root of what the decision-making criteria is — and be able to influence it. A lot of times, the influencing is not numbers or money, like a lot of people incorrectly believe. It’s rather emotional. So taking control of the call, leading the call, leading the patient — even as simple as, "Hey, my name is Jenny. Who am I speaking with?" — is a way to take control of the call.

And the third biggest mistake I see people answering the phone make is not asking for the appointment. And that’s huge, right? Because you spend five minutes, seven minutes answering all the questions, but if you don’t have an appointment, you don’t know who this patient is — you lose them. All of that marketing dollars is now wasted, and all of your time is wasted.

Naren Arulrajah: So how do you ask for appointments? One of the best ways to ask is to give them choices. "Do you prefer morning or evenings?" And remembering that your number one goal for that particular phone call is to get that appointment booked. "Do you prefer early in the week or later in the week? What about Tuesday at 3:00 PM?" So it becomes part of the conversation. So always, always learn to ask for appointments.

Once again, it’s a mindset of the person answering the phone call. It’s taking control. And last but not least — asking for the appointment, taking control of the call.

I’m gonna give you a bonus tip. This is specifically for practice owners and managers. The bonus tip is: you need to know what your call conversion rate is. If you don’t know what your call conversion rate is, you can’t improve it.

Naren Arulrajah: We offer that as part of our service at no extra charge for our clients. And the average dental practice in the U.S. is only booking one out of three new patient calls. So it’s around 33%. If you’re like the average, you have an opportunity to double your practice or even triple your new patient side of your practice.

If you want to learn more about this and other things around marketing, book a marketing strategy meeting with our team. We spend six hours researching you, researching your competition, and giving you a detailed plan on how to dominate. And the link for that is ekwa.com/td.

Naren Arulrajah: Welcome back to the Thriving Dentist Show. This is Naren, your co-host. The topic we’ll be covering today is Recommendations to Effectively Schedule Patients With Uncompleted Treatment Plans. Recommendations to effectively schedule patients with uncompleted treatment plans.

Hope you enjoyed that tip about how to answer your phone. If you have any questions in terms of that or growing your new patient call volume, book a marketing strategy meeting — we would love to help. The link is ekwa.com/td for Thriving Dentist — ekwa.com/td. We’ll put a link also in the show notes.

Gary, this is a problem I have dealt with, and I’ve seen firsthand literally for a decade or more. Of course, you are the expert. You are the coach. You are the one with — you know — 48 years, if I’m not mistaken… 46, 46, 46, 46, 46 years of experience in dentistry. And I’ll tell you a story that is near and dear to me, right?

Naren Arulrajah: I don’t want to name names, but this one dentist I’m very close to — consider them like a family friend — I was visiting their practice, and they were talking about their challenges and stuff. And I realized they have 5,000 patients in their database, but they only have like 1,500 active patients. And many of those 5,000 patients — or 3,500 patients — are no longer active. And even the active patients had so much unscheduled treatment.

So something went wrong. They come in, they get excited, they come regularly for six months, one year, whatever the duration — and then things just fall by the wayside. And now the practice is busy getting new patients. Of course, as a marketing company CEO I like that. But it’s not sustainable, right?

When you can’t do the work, the unscheduled treatment, as well as keep your patients, it becomes an unsustainable business model. I mean, imagine — they’re working so hard to get new patients, but it’s like a leakage. You know, either they don’t accept treatment, or…

Gary Takacs: …they have the back door wide open.

Naren Arulrajah: Exactly. They have the back door wide open. And of course, I’m not a coach, so I recommended that they reach out to you and talk to you. And I know you helped them. I’m sure you remember this particular individual that I’m talking about.

And I guess that’s the topic of our conversation today, right? And especially this is true for the established practices. Of course, new practices — they’re gaining a lot of new patients, so they don’t notice it. But the longer you’ve been there — like the example I gave you — very large patient pool, but only a few active, engaged patients who are accepting treatment. So that, like you said, the back door open problem.

So that’s the conversation we’re going to have today. So Gary, let me start by asking you: Why are unscheduled treatment plans such an epidemic in dentistry?

Gary Takacs: Well, if you’ve been a regular listener of the Thriving Dentist Show, you’ve heard me refer to one of my mentors by the name of Dr. Omer Reed. Dr. Reed had a tremendous influence on me. Any of you that haven’t heard of him, I would encourage you to Google that name — Omer, O-M-E-R, Reed, R-E-E-D — and see what you can learn about Dr. Reed. It’s fascinating.

But he taught me years ago — years ago — and this was before offices were computerized, right? And back then we had paper files, if you can imagine this. We’re talking about ancient dental history here. We had paper files, paper charts, and they were kept in file cabinets, alphabetized.

And Dr. Reed said, most dentists are file cabinet millionaires. Now, Omer said that, Naren, at a time when there was an author who wrote the book How to Have a $100,000-a-Year Dental Practice.

Gary Takacs: …literally implode your printer and run out of paper and ink, because it will be many, many, many, many pages long. So even if you’ve been in practice a relatively short period of time, you likely have millions of dollars of unscheduled treatment.

Unscheduled treatment is treatment that’s been recommended but hasn’t been completed. So how do we—why are unscheduled treatments such an epidemic? And the simple answer to that, Naren, is: the office doesn’t have a system for it. It doesn’t have a system. And when we don’t have systems, it’s just random, right? It’s just a random thing that we do when the doctor comes to the team member and says, “Do this.”

And so here’s how it happens in most practices. Doctor’s feeling the pressure of the schedule not being as full as he or she would like. And they go to a scheduling team member and say, “Hey, please work the unscheduled treatment list, because I looked ahead and the schedule isn’t what I’d like. Please work that.”

And that’s their quote. That’s how they handle it. But can we agree that’s not a system at all?

Naren Arulrajah: Yeah. I’m just thinking while you’re speaking, Gary, there’s a lot of leakage, right? For some reason, the patient didn’t accept treatment. Some reason the patient stopped listening to the doctor — even when it comes to recalls and coming back and keeping those issues from not getting worse. And then it becomes this colossal failure.

So on paper, like you said, they’re worth $5 million, $7 million in terms of dentistry. But in reality, it’s like a business with a wide open door in the back — and everything keeps walking out. Just keeps walking out. So it doesn’t matter how much you try to fix the front door, or the side doors — it doesn’t work.

Gary Takacs: No. It’s like the company that constantly depends on new customers to build their business instead of taking care of existing.

So let’s talk about some reasons why. Why do patients not accept treatment? That’s a fundamental “why.” Well, a possibility — doctors, have a little bit of a thick skin — it may not have been presented effectively. It may not have presented the dentistry in such a way that encourages people to move forward with treatment.

And I’m not suggesting salesmanship. I’m not suggesting hyping something that doesn’t need to be done.

Another reason is there’s a fundamental flaw in how dentistry is presented. The way you were taught in dental school is fundamentally flawed. Identify a problem, present a solution. Identify a problem, present a solution.

 

Gary Takacs: I believe that that is probably the only way it could be taught in dental school. But when we go past dental school, it’s a failed method. Because if you present—identify a problem and you present a solution—there’s a big missing piece between the two. You haven’t identified if there’s any interest on the part of the patient. You haven’t identified if there’s interest. If they’re asking you, "Hey doc, I’m concerned about this," or, "I noticed my teeth seem to be crowded," what are they saying? They’re saying, "I’m concerned about this."

Naren Arulrajah: Yeah. Now they want a solution. Now they want help.

Gary Takacs: But if you’re presenting a solution for crowded teeth and they haven’t even shown that they’re interested in it, it’s falling on deaf ears.

Naren Arulrajah: Step one is to get them interested — get them to care. I know, like, you talked about close-ups, right? Like the iPad and the close-up. That’s one of the signature—

Gary Takacs: Very simple thing to do. Use Dr. Frank Spear and his six digital photos for patient education. I want to credit Frank for teaching me that many years ago. All of you have heard of Dr. Frank Spear. Take his six photos for patient education. And those are not intraoral — we’re not taking those with an intraoral camera. We’re taking them with a digital camera.

Now, one thing that’s happened, Naren — the technology has moved beyond digital photos. It’s moved to scanning.

Naren Arulrajah: Like, one of the things—

Gary Takacs: I love scanning. Hold this aside — I love scanning. Scanning’s amazing. But the scanning doesn’t have it— It has value to the patient. The patient can understand things they see in the scan. But everybody understands photos.

Why does everyone understand photos today, Naren? Why? Why does everyone understand photos?

Naren Arulrajah: I mean, iPad, big screens, right? They live on them…

Gary Takacs: It’s even more— it’s even more fundamental. Why do they understand photos? Look at the screen. Look at my screen.

Naren Arulrajah: Because they see it.

Gary Takacs: They have a phone. Look. Look at the photo.

Naren Arulrajah: Yeah, yeah, yeah.

Gary Takacs: They have a phone, and we take photos, right? And they zoom in. They understand photos. Right? They understand photos.

So we take six digital photos. We upload them to an iPad. I’d recommend getting the largest iPad you can. Okay, I’m an Apple fanboy, so buy the iPad Pro — the 12.9-inch diagonal screen. It’s huge. You want that screen real estate to be as big as possible.

Upload those six photos. Leave the room. Make an excuse to leave the room. “Naren, you might remember when we took those photos earlier in your appointment today? I went ahead and loaded them onto the tablet here.” And I hand you the tablet.

“Doctor and I need to take a look at your digital radiographs and look at the digital scan we took. While we’re doing that, do me a favor and take a look at these photos. Once we come back, we’ll be happy to answer any questions you have.”

Now, we leave you alone for two or three minutes. We come back…

Naren Arulrajah: Mm-hmm.

Gary Takacs: …and now they start. “Oh, what’s this? What’s that? What’s this?” Right? Now they’re asking you.

 

Naren Arulrajah: Yeah. They’re interested. They want solutions instead of you selling them things. Yeah, I think that’s a huge breakthrough, Gary. And I know sometimes when you ask the same "why" multiple times, you get deeper in defenses, right?

One of the stats that I remember hearing from Dental Intel — who’s a close partner of ours — is doctors have stopped presenting ideal care because they’re in PPO practices, and they’ve heard too many "no’s" too often. And they’re like, give up. They’re like, “Okay…”

Gary Takacs: Bang your head against the wall too many times… You bang your head against the wall…

Naren Arulrajah: Exactly.

Gary Takacs: And sadly, what that does — it becomes kind of self-fulfilling. If you’re not presenting it, you’re never gonna get acceptance. You’re never gonna get that acceptance.

And you know, that’s another fundamental thought — they think all their patients now, all they’re interested in is what’s covered by insurance. So they only present what’s covered by insurance. And then we lose any opportunity to do high-value dentistry, because insurance doesn’t cover high-value dentistry.

But I mean, those are just some of the reasons. There’s any number of reasons.

And very often — this is something I’ll come back to with Dr. Reed. Early in my career, I was invited with Dr. Reed to co-teach with him a three-day course on case presentation.

Gary Takacs: Now, three days. It started at 7:00 in the morning, finished at 7:00 in the evening, and it was Thursday, Friday, and Saturday. It quite literally was 36 hours of technique and skills building around how to present dentistry. And Omer wanted to have a non-clinician — that was me — present with him as a clinician. And we made a good team together. It was amazing.

But one of the things that he taught me in that is: If you must speak, ask questions.

Now, if you’re listening to this — I want you, if you’re driving, don’t take your hands off the wheel — but as soon as you get to your destination, put that note in your phone. In the notes, in your plan, in your phone: If you must speak, ask questions.

Because too often, the patient will say, “I didn’t realize my teeth were so crowded,” and the dentist immediately goes to — let’s just say they’re a candidate for Invisalign — they immediately go to Invisalign.

But you’re rushing it along.

If the patient says, “I didn’t realize my teeth were so crowded,” now — if you must speak, ask questions. “Naren, does that concern you?” What are most people gonna say?

Naren Arulrajah: Yeah, of course.

Gary Takacs: That absolutely…

Naren Arulrajah: Yeah, it definitely concerns me.

Gary Takacs: Yeah. And the more you ask questions, the more you learn about where they are and how they’re thinking about it. And it allows you to really be in sync with the patient in terms of understanding where their interests are.

I mean, if you point out a space between their teeth and they have no interest in correcting it — I mean, David Letterman, the late-night TV host for many, many, many years — Naren, do you remember his smile?

Naren Arulrajah: No, Gary.

Gary Takacs: Google it. Google David Letterman’s smile, and you’re gonna see a huge gap between his front teeth.

Naren Arulrajah: Oh yeah, yeah, yeah. I remember now. Yes. Yes.

Gary Takacs: Yeah. But guess what? Was it money? So why didn’t Letterman have something done about that?

Naren Arulrajah: I think it just — nobody convinced him, or nobody created that eager desire where he wanted to get it done. I mean, like the simple technique of showing the pictures and making them want to have it… perhaps that didn’t happen with him. That’s my guess.

Gary Takacs: Well, I think it’s more fundamental.

Naren Arulrajah: Okay.

Gary Takacs: He didn’t care.

Naren Arulrajah: Right. He didn’t…

Gary Takacs: Care. He kind of considered it his signature thing. He did not care.

I mean, he had the money, right?

Naren Arulrajah: He made — what — $2 million an episode or something? So I’m sure he had the money.

Gary Takacs: Obscene. Very talented. But, you know, he didn’t care.

Now a more contemporary example. Google — I’m gonna ask you, Naren, I’m gonna ask you to Google this: Michael Strahan. S-T-R-A-H-A-N. Strahan. Google it. Yeah. Look at his smile.

Naren Arulrajah: Oh man, that is so—like, that is just…

Gary Takacs: Out there. So, Naren, is Michael Strahan…

Naren Arulrajah: He’s an NFL commentator, right?

Gary Takacs: Again, I don’t think he’s making minimum wage.

Naren Arulrajah: Yeah, yeah, yeah. Exactly. He’s making millions and millions.

Gary Takacs: I think he has insurance.

Naren Arulrajah: Yeah, yeah, yeah. Exactly.

Gary Takacs: Besides that, he’s got a big fat bank account. Yeah. Look at his smile.

So, you know, sometimes there just isn’t the interest — and that’s okay. Right?

And apparently, Michael Strahan thinks that if you can drive a truck between his teeth — that’s okay.

Naren Arulrajah: Yes.

Gary Takacs: You know…

Naren Arulrajah: And he’s 54 too, so it’s not like he hasn’t… I bet it’s not like he hasn’t noticed it.

Gary Takacs: It’s his thing. It’s now his thing.

 

Naren Arulrajah: It’s not his thing, yeah.

Gary Takacs: The point is: if you must speak, ask questions. Learn how to ask. So an easy phrase — it’s actually three words — "Tell me more."

Naren Arulrajah: Tell me more. Mm-hmm.

Gary Takacs: Tell me more. And now the patient’s talking, and you’re listening. And then at some point, you can now start to pivot and start to present some solutions. And if they’ve expressed interest and then you present a solution, we now have the right sequence in order — because they’ve asked for help, right? They’ve asked.

I mean, Naren, imagine if you were to walk down the street — I know you enjoy traveling — if you were to visit New York City and you’re walking down the street and a stranger comes up to you and says, “Hey, can I give you fashion advice?”

Naren Arulrajah: I’m not going to listen to the stranger.

Gary Takacs: Maybe they’re in New York — it’s a fashion capital. Maybe they have a lot of expertise. “Sir, would it be okay if I give you some fashion advice?”

Naren Arulrajah: If I care about it and you ask my permission — yeah. And if I say yeah…

Gary Takacs: Otherwise, you’re probably gonna be offended.

Naren Arulrajah: Yeah, yeah.

Gary Takacs: But instead, if you go to someone that has a business around that — and you go there seeking it out — that’s a different story.

Well, it’s the same thing. We want patients to express some interest. And the photos are the best way to get people to begin to understand what’s going on with their mouth.

Now, they won’t say anything earth-shattering. They won’t say, “I don’t like the incisal translucency on 8 and 9.” They won’t say, “I don’t think I’m in canine guidance.” They’ll never say that.

Naren Arulrajah: Yeah.

Gary Takacs: What are they gonna do? They’re going to speak to the obvious: “I’d like my teeth to be whiter.” “I’d like them to be straighter.” “I’d like them to be…” — exactly.

And the photos give them the opportunity to speak to that. And then they are showing some interest in that.

But good question, good way to start this off. You know — why are unscheduled treatment plans such an epidemic? There’s many reasons.

Well, now let’s get into some of the more tactical stuff, Naren.

Naren Arulrajah: Yes. Gary, let me jump into a tactical question — that is: What are the biggest mistakes practices make when they try to reactivate patients?

See, like — this is the story I told you at the beginning of the episode, right? 5,000 patients, 3,500 need to be reactivated.

Gary Takacs: Yeah. So — and I’m specifically talking about following up on unscheduled treatment plans. Rather than reactivating past-due hygiene. Specifically talking about follow-up on unscheduled…

Naren Arulrajah: But aren’t they kind of linked, Gary? In the sense that usually the people who are not showing up for their hygiene are also the ones who have unscheduled treatment?

Gary Takacs: Very, very often, yes.

However, think about this: when you’re calling — or when you’re contacting them — to follow up on unscheduled treatment plans, we should have two goals.

One goal would be to get them scheduled for the unscheduled treatment plan. We should have a fallback position if we’re not. And the fallback is, “Oh, Naren, I noticed we don’t have you scheduled for your next hygiene appointment. Let’s go ahead and make that.”

Let’s say you’re not ready to schedule the elective treatment — but then I’m going to bring you back.

Naren Arulrajah: Let me ask you this: I’m calling one person who has unscheduled…

Gary Takacs: We’re not calling.

Naren Arulrajah: Oh sure — we’re calling, texting, whatever, right?

Gary Takacs: No, no. We are not calling. I want to be clear — we are not calling.

Naren Arulrajah: Not calling, right.

Gary Takacs: When I’m talking to my clients — and I’m gonna get vocal on this — and they say, “No, she calls everybody,” I say, “Stop. Stop. Stop. Stop.”

Naren Arulrajah: People don’t answer.

Gary Takacs: In 2026, we do not call people. We do not call — because you will get nothing but voicemail. And they will not listen to any voicemail.

So we are texting patients.

Now, granted, there are rare exceptions to that. If you have super-seniors in your practice — 80 and older…

Naren Arulrajah: Yeah.

Gary Takacs: We call them — but we’re not calling even the seniors in their seventies. We’re texting them.

So we text. This is very, very important. Because when I’m reviewing with clients and they say, “Oh yeah, we’re calling everybody,” well, that’s part of the problem — because it’s an exercise in someone spinning their wheels, and they’re making no connections, no contacts with any of those people. So we do not call them.

Naren Arulrajah: Right. I guess my question was, if they have both unscheduled hygiene and unscheduled treatment — which one do you ask? Because remember, on text, you can only start with one, right?

Gary Takacs: We start with the unscheduled treatment.

Naren Arulrajah: Okay.

Gary Takacs: But then let’s say they reply, “Well, I’m not quite ready.” We can continue the text — now we’re in communication. We’re texting back and forth, right?

And we can say, “I noticed that we don’t have you scheduled for your next hygiene appointment. That might be a good next step. Can I schedule your hygiene appointment?”

Now — I also want to emphasize — one of the biggest mistakes we make when we’re following up on unscheduled treatment is that we don’t give them a benefit statement.

It’s just, “Hey Naren, I’m reaching out to you to schedule the treatment the doctor recommended.”

No benefit statement.

Naren Arulrajah: Right.

Gary Takacs: So if it’s fillings — old fillings that need to be replaced — what’s the most common reason the patient wouldn’t have accepted replacing those old fillings? Old amalgam fillings that are breaking? What’s the most common reason?

Naren Arulrajah: Yeah, the most common reason is… it doesn’t hurt.

Gary Takacs: It doesn’t hurt.

Naren Arulrajah: Yeah.

Gary Takacs: So we say — we can give them a benefit statement. We can anticipate it in the message:

“If we wait till it hurts, the fillings may not be able to be replaced with just fillings. It may end up being root canals and crowns. And that benefits us — but not you. It’d be good for us to get this taken care of before it becomes something more complicated.”

And that’s a generic thing. Again, I could get very nuanced about this depending on the treatment. But a general statement that your team members can accurately make:

“It’s a good idea to get this done before it becomes something more complicated.”

Now they have a reason to do it. Right?

Instead of just someone calling me and trying to get me to do something — or… oops, I fell into the trap — someone texting me, now you’re giving them a reason.

So that’s a big mistake.

Naren Arulrajah: And I also agree — if they don’t accept the unscheduled treatment, the hygiene could be a great backup. Like, in order to make sure it doesn’t get worse, why don’t we book you in for a hygiene appointment?

Gary Takacs: Another mistake is they just don’t have any system for it. We don’t know where to go to get the list. You know?

So if you’re a team member that is flying by the seat of your pants, and the doctor says, “I need the schedule to get filled,” — you don’t have a really good way of identifying patients with unscheduled treatment and starting the process.

Now, technology can help us a great deal there. Technology can help a lot. Things like Dental Intel — where they can quickly pull a report of people with unscheduled treatment…

Naren Arulrajah: Hold that thought, Gary. I know there’s a follow-up question on the system and so forth.

Gary Takacs: We’ll come back to that. And it also isn’t dedicated time that they have carved out on the schedule to do this routinely. It just becomes something they do when they get pressure from the doctor because the schedule wasn’t as full as we’d like.

So those are just some of the reasons.

Naren Arulrajah: Got it. Makes sense, makes sense.

Next question I want to touch on, Gary, is: How far back should a practice realistically go when following up on unscheduled treatment plans?

And also — I want to know — you talked about having time in the routine so you don’t let, you know, unscheduled treatment plans get behind by months and years and so forth. But answer that as well: How much time would you allocate on a weekly basis?

Gary Takacs: Yeah, great questions, Naren. So first of all — how far back? Because we’re doing this very efficiently using technology, by texting, it’s a way more efficient process than it ever was by phone. So that allows us to go back.

And I want to frame it with kind of an example for you — any dentist listening to this — I want you to think about yourself in this scenario:

Imagine yourself at the grocery store, pushing your shopping cart down the aisle at your community grocery store. And imagine, on the other end of the aisle, a person is heading your way with their shopping cart — and they’re a patient of yours. And they haven’t been in your office for three or four years.

And the patient says to you, “Hey Doc, good to see you!”

They still think you’re their dentist. They haven’t gone anywhere else. They haven’t gone anywhere in the last three or four years. They still think you’re their dentist.

Naren Arulrajah: Right.

Gary Takacs: There’s an element of human nature in memory that’s very flawed — and that is, we think something happened more recently than it did.

That patient pushing their cart thinks they were in your office maybe a year ago…

Naren Arulrajah: Exactly.

Gary Takacs: …and it’s been four years.

I was sharing this with a client of ours, Naren, in Thriving Dentist Coaching, and we were on a Zoom call. His eyes got really big, and he said, “Oh my gosh, Gary, how true is that?”

He said — true confession — he’s 60 years old, I won’t use his name. But he said, “I’ve generally been really good about getting my annual physical from my primary care physician, but I had gotten kind of off my schedule. It had been a little while. So I called the office…”

And he said, “Beth, it’s Dr. So-and-so. I’m a little behind on scheduling my annual physical. It’s been about three years. Can I schedule my annual?”

And the office manager said, “Doctor… it’s been eight years.”

He said, “Gary, if I’d had a polygraph test on my wrist, I would’ve passed. I believed — with every ounce of my DNA — that it had been three years. In fact, it was eight years.”

And that’s what happens.

So how far back should you go? As we’re recording this — in 2026 — I’d go back to 2019. I’d go back to 2019 because you can do it so efficiently.

Start with the most current, but go back. Because it’s likely they haven’t gone anywhere else. And the reason I’m saying 2019 specifically is — what happened in 2020?

Naren Arulrajah: COVID.

Gary Takacs: And what happened to everyone’s patterns after that?

Naren Arulrajah: Yeah, I think some people… yeah, it all got messed up.

Gary Takacs: So I’d go back to 2019. You can do it so efficiently. And hey — if it turns out they’ve moved, gone somewhere else, fine. But it’s not taking you much time.

And if they haven’t been to the dentist since 2019 — Naren, we’re now talking about seven years ago. How does their mouth look?

Naren Arulrajah: Excellent…

Gary Takacs: No — the opposite. It looks horrible.

Naren Arulrajah: Oh, you mean if they haven’t been there since 2019? Of course, yeah, yeah, yeah.

Gary Takacs: And there is — guess what — opportunity with that patient.

Naren Arulrajah: Especially with sedation. If you do sedation and you have lots of work to do…

Gary Takacs: Their mouth is in a mess. Because they haven’t had any professional care. In terms of value of treatment plan, that’s a valuable one to follow up on.

Now, as far as the dedicated time — to answer that second part of your question, Naren — I would suggest that every practice has two hours a week of dedicated time. It could be broken down into hour segments, but at least two hours a week to follow up on unscheduled treatment plans.

Naren Arulrajah: And it depends on the size of the practice too, right?

Gary Takacs: That’s for a solo dentist practice. And of course, you can adapt that based on the size of your practice, for sure.

Naren Arulrajah: Right. Thank you so much, Gary. Really appreciate it.

Let me jump into the next question, which I think is a really important one:

You have an excellent system to follow up on unscheduled treatment plans. I know this is something you reserve for your clients, but can you at least explain — at a high level — how this works?

Gary Takacs: Yeah. We actually have two — it’s two separate systems in our 24 systems. By the way, if you’re a regular listener, you can go back and get our episodes on the 24 systems.

But we have one system to follow up on everyday general dentistry. One system to follow up on that — for everyday dentistry like fillings, root canals, crowns — those kinds of things.

And we have another system to follow up on what I call high-value dentistry. High-value dentistry includes things like implants, Invisalign, cosmetic dentistry, complex restorative, oral conscious sedation — maybe we’re diagnosing and treating obstructive sleep apnea. We have a different system for that.

They’re similar, but they’re different.

And we have individual spreadsheets. For example, the way we do the everyday general dentistry is we have an Excel spreadsheet for every month in the practice.

Gary Takacs: The new patients that had treatment plans coming out of their new patient visit — they go into that spreadsheet. We separate it from the practice management system, because the practice management system can become a dark hole that things just disappear into.

So now we pull up — for example, if we’re recording this in January 2026 — then we have a spreadsheet for any new patient that came through as a new patient with treatment needed or recommended. That goes into a January 2026 spreadsheet.

The columns simply have:

• The date,
• The name of the patient,
• A shorthand for the treatment — not the full CDT codes. It’ll just say “fillings upper,” right?
• Another column for notes as we’re following up with them,
• And the last column is Scheduled / Unscheduled.

Then we follow up with those patients.

Gary Takacs: So we have a system set up where — by the end of the following month — so in this example, January 2026 — the scheduling coordinator follows up with every one of those patients between now and the end of February 2026.

Because we want to follow up with them while it’s still fresh.

And the team member has to come to the meeting with the doctor on follow-up for the unscheduled treatment with the notes all filled out. And it either needs to be:

• They’re scheduled,
• Or we know the reason why.

And a possible reason — not necessarily a good reason, but a possible one — is: “They’re just not ready to move forward with treatment.”

But now we know — they aren’t just disappearing into space. The patient’s not ready to move forward with that.

Gary Takacs: Then the next thing we do is we check to make sure we have their next hygiene appointment. And if we don’t, then we work to get that hygiene appointment scheduled.

It’s a foolproof system — and no one can slip through the cracks.

We have a similar system for the higher-value dentistry. It’s just a little softer, because we just want to know:

• What is the reason why they’re not ready to move forward?
• And we know what the next step is.

Maybe the next step is, “Check in with me in the summer,” or, “I’m waiting for my income tax refund check.” We know why.

But those systems work really, really well.

Naren Arulrajah: Thank you, Gary. That’s excellent. How do you get the team to run this without constant reminders? This is the million-dollar question, right? Because we all know what to do, but if you look at the people who actually do what’s important — like in this particular topic — consistently, it’s a minority.

I know your clients are an exception because you really follow up with them, or your team follows up with them and tracks certain metrics and everything else. But I’m talking about the average practice…

Gary Takacs: Well, two things.

Number one is I would look at designing a favorable incentive system for your team members — so that way they’re as motivated for doing it as you are. Not everything needs to be incentivized — let me be clear about that. Some things should be just part of their job. But I might suggest that we have an incentive system for them so that your goal becomes their goal.

Now, there are many different ways to do that, so I want to stop short of saying there’s a generic way to do it. It’s got to be designed for your practice.

But then, the second thing is — I’ll tell you what not to do, Naren: Don’t wait for a year and then have a review meeting and beat up on them for what they didn’t do.

Naren Arulrajah: So you need to do check-ins, right? At least—

Gary Takacs: Have regular check-ins.

Naren Arulrajah: Regular check-ins. What do you recommend? Weekly? Monthly?

Gary Takacs: On the everyday general dentistry, we have a check-in every month — because we’re following up on the previous month. And they have to come to that meeting with the spreadsheet filled out. We either have the patient scheduled, or we know the reason why.

It’s that simple.

So if I’m having a conversation with the team member — let’s say the team member’s name is Maria — I’d say: “Maria, when you come to that meeting, I want to know if they’re scheduled or the reason why. And there are any number of acceptable reasons — I just want to know why.”

Now we have clarity, and we have a regular…

Naren Arulrajah: And how old can the spreadsheet be? Can it be two years old, or does it have to be—

Gary Takacs: In this case, we’re following up from the previous month, so it’s current.

Naren Arulrajah: Oh, okay — just the previous month. Got it, got it, got it.

Gary Takacs: It really is just a way to do something consistently. Engineers understand systems.

Naren Arulrajah: Yes, yes.

Gary Takacs: They understand systems — because their whole world runs on systems. Now we put systems in place in your practice where it’s not like out of sight, out of mind — it’s just a regular part of their activity. And it’s systematized.

Well, this has been a fun discussion. I would love to help any of our listeners change the situation of being, you know, file cabinet millionaires — in the old language.

I’d love to help you get your patients moving forward with recommended treatment — doing it softly, doing it gently, doing it by listening — and really helping the treatment become their idea.

The best way to get treatment done is to have the treatment become their idea. Have the treatment become their idea.

After-photos — after-photos in your office. Large-format after-photos. Beautiful, healthy people, smiling. Actual patients of yours.

Naren Arulrajah: Right.

Gary Takacs: That’s going to plant a seed — that a beautiful, healthy smile is appropriate for anybody. And then they start asking questions about it.

Well, that’s maybe a topic for another day.

Naren, as we wrap up today — if any of our listeners were motivated by this episode, and they would like to have more effective systems in their practice, they’d like to have less stress, they’d like to have a thriving practice that provides personal, professional, and financial satisfaction — I’d encourage you to schedule a coaching strategy meeting with me.

Go to thrivingdentist.com/csm. That’ll be a Zoom meeting with me. It opens up my calendar. It’ll be a Zoom meeting — we can talk about your practice, talk about your goals, and talk about how we can help.

We are accepting new clients. We don’t always — sometimes we have a waitlist. We’re currently accepting new clients because we’ve recently been able to help a number of our clients hit the finish line successfully — by plan. And it’s opened up an opportunity for us to add some new clients.

If that’s of interest to you: thrivingdentist.com/csm

And if your issue is: you need more new patients — I would encourage you to set up a marketing strategy meeting with Ekwa. Naren, what’s the URL for that?

Naren Arulrajah: It’s ekwa.com/td — for Thriving Dentist. E-K-W-A.com/td

Gary Takacs: Yeah, I’d highly recommend that if you’d like more quality patients and less dependence on PPO plans. Ekwa can be a great partner for you on that.

On that note, Naren and I want to thank you for the privilege of your time today.

We look forward to connecting with you on the next Thriving Dentist Show.