# Patient Recall Engine - Go To Market Owner: Mike Rodgers. Solo operator. This document is the actual playbook, not a summary of one. --- ## 1. ICP **Who buys this** | Dimension | Target | |---|---| | Practice type | Private general dentistry, owner-operated. 1-4 locations. | | Collections | $1.2M - $8M/yr. Below $1.2M there is not enough dormant base. Above $8M you are usually talking to a DSO committee, not an owner. | | Ops | 2-6 operatories, 1-3 dentists, 2-4 hygienists | | Lapsed base | **1,000+ patients not seen in 12 months.** This is the single hard qualifier. | | PMS | Dentrix, Eaglesoft, Open Dental, Curve. All export cleanly. | | Existing stack | Already pays for Weave / RevenueWell / Solutionreach / Lighthouse 360. Good sign, not a blocker. They already believe recall matters and already have a delivery channel. | | Who signs | The owner-dentist. Practice manager is the champion and the daily user, but does not sign. | **Who does not buy this** - Under 800 lapsed patients. The math does not clear break-even and I will say so. - Pure specialty (ortho, oral surgery, endo). Referral-driven, no hygiene recall engine to restart. - Practices sold to a DSO in the last 12 months. Procurement is frozen and the DSO has a stack mandate. - Practices with an active PPO-to-FFS conversion in flight. They are deliberately shrinking their patient base and are not trying to bring old patients back. - Anyone currently getting >8% reactivation on their full lapsed list. They have solved it. **Why they buy now vs. later:** the insurance year. Unused benefits expire December 31. That is a real, dated, external deadline that does the urgency work for me. Q3 is the selling season. --- ## 2. Trigger events Ranked by how reliably they turn into a booked call. 1. **Hygiene schedule holes.** A practice posting "hiring hygienist" while also having open hygiene columns is not short on staff, it is short on patients. This is the strongest signal and it is public. 2. **New associate dentist hired.** Somebody just added capacity and now has to fill it. Fresh chair time with no patient base attached. Found on Indeed/ADA job boards and practice Instagram. 3. **September through November.** Benefits-expiration season. Every practice is thinking about it. Highest-converting cold window of the year. 4. **Practice acquisition or relocation.** New owner inherits a patient list they did not build and has no relationship with any of them. The dormant list is the only growth asset they own outright. 5. **Recently cut marketing spend.** A practice that stopped Google Ads is looking for cheaper patient acquisition. Reactivation is the cheapest there is. 6. **Added a second location.** Doubled overhead, same patient base. 7. **Switched PMS in the last 6 months.** Recall automations broke during migration and nobody rebuilt them. There is usually a 6-18 month hole in their outreach. --- ## 3. Cold email sequence Five emails over 19 days. Plain text, no images, no tracking pixels, one link maximum and only after email 3. Sent from a subdomain, not the root domain. **Merge fields:** `{{first}}` `{{practice}}` `{{city}}` `{{ops}}` `{{years}}` --- ### Email 1 - Day 0 **Subject:** `lapsed patients at {{practice}}` ``` {{first}}, Quick math on a practice the size of {{practice}}. A {{ops}}-op general practice usually carries somewhere between 1,200 and 1,900 patients who have not been in for over a year. At roughly $860 of first-year production each, that is north of a million dollars of production sitting in your own database. Your front desk will never call all of them. That is not a criticism, it is 200 hours of phone time. I built something that scores which of those patients will actually come back, ranks them by what they are worth, and runs the outreach. Worth 20 minutes? Mike Rodgers ``` *Why it works: no product name in the first email, no link, no attachment. It leads with their number, not my feature. The "that is not a criticism" line pre-empts the defensive read of "your front desk is failing".* --- ### Email 2 - Day 3 **Subject:** `re: lapsed patients at {{practice}}` ``` {{first}}, Following up with the part that actually matters. Most reactivation campaigns get 2-4%. Not because the message is bad, but because they send the same message to all 1,600 people. The patient who moved to Arizona and the patient whose husband is still on your schedule every six months get the same text. In our own cohort, 31% of the lapsed list holds 70% of the recoverable value. Rank first and the same front desk hours produce roughly four times the production. Do you know how many of your patients are past 12 months right now? Most owners are off by 40% in either direction. Mike ``` *Why it works: ends with a question the owner genuinely cannot answer, which is the actual hook. The "off by 40%" line makes not knowing feel normal rather than embarrassing.* --- ### Email 3 - Day 7 **Subject:** `the 6.6% line` ``` {{first}}, Being straight with you about where this does not work. The math on a 3-op practice with 1,600 lapsed patients: 144 incremental patients recovered at 12% vs a 3% blast x $863 first-year production each = $124,272 gross x 38% contribution margin = $47,223 less $18,900 cost of the system = +$28,323 net year one Break-even is 6.6% reactivation. Under that this costs you money. Roughly one practice in five I look at does not clear it, usually because the lapsed list is too small or too old. I tell those practices no. I would rather not sell it than sell it and have it not work. If you want, send me a count of patients past 12 months and I will tell you which side of the line you are on. No call required for that part. Mike ``` *Why it works: this is the conversion email. Publishing the failure threshold and the "one in five gets a no" line does more for credibility than any case study, and the ask is a single number by reply rather than a meeting.* --- ### Email 4 - Day 12 **Subject:** `December 31` ``` {{first}}, Timing note, then I will leave you alone. Unused insurance benefits reset December 31. Every patient on your lapsed list with an active plan has a dated, expiring reason to come back that you did not have to invent. That window is worth roughly double the rest of the year, and it needs about six weeks of runway to work. Setup is ten business days. If you want it running before the benefits season, now is when that decision gets made. 20 minutes: {{link}} Mike ``` *Why it works: the only email with a link, and the only one with real external urgency. The deadline is the insurance calendar, not a fake discount.* --- ### Email 5 - Day 19 **Subject:** `closing your file` ``` {{first}}, I am going to stop emailing you. If it is a timing thing, reply "later" and I will check back in the spring. If you want the analysis without the sales process, reply with your count of patients past 12 months and I will send back what the top 200 are worth and how the value is distributed. That is genuinely useful whether or not you ever buy anything from me, and it takes me about an hour. Either way, good luck with the rest of the year. Mike ``` *Why it works: real breakup, gives a one-word low-friction out, and the final offer is a free deliverable with no meeting attached. Historically the highest-reply email in a sequence like this.* --- ## 4. LinkedIn posts ### Post 1 - the contrarian take ``` Most dental reactivation campaigns fail before the first message sends. Not because of the copy. Because of the list. A practice has 1,600 patients past 12 months. The software can text all 1,600 on Tuesday. So it does. But a patient who moved to another state and a patient whose spouse is still on your schedule every six months are not the same patient. They get the same message. Result: 2-4% book. And a few hundred people opt out of the channel you needed for the ones who would have said yes. The fix is not a better template. The fix is deciding who to contact before you decide what to say. In the cohort I work with, 31% of the lapsed list holds 68% of the recoverable value. Rank first, and the same front desk hours produce about four times the production. Most practices are paying for a megaphone and pointing it at a list nobody has ever sorted. ``` ### Post 2 - the teardown ``` Here is what 1,400 lapsed patients is actually worth. Real math. Start: 1,400 patients past 12 months. Blast everyone with a recall tool: 3% book. That is 42 patients. Now rank them instead. Score each on months lapsed, prior visit count, no-shows, unused insurance benefits, outstanding balance, treatment diagnosed but never scheduled, whether anyone in the household still comes in, distance, and the reason they left. Work the top 430 only. 12% of the full list books. 168 patients. 126 incremental patients over the blast. At $863 first-year production each: $108,738. At a 38% contribution margin: $41,320. The front desk did not work harder. It worked 430 people instead of 1,400, and it worked the right 430. The other 970 got suppressed, which is its own win. Every message to somebody who will never return costs you an opt-out you needed for somebody who would have. Break-even on a system like this is around 6.6%. If your list will not clear that, do not build it. Some will not. ``` ### Post 3 - build in public ``` Shipped the scoring model this week. Notes from calibrating it. First version had a median return probability of 56%. Obviously wrong. Real dental reactivation runs 3-18% depending on how you work the list. The model was confidently telling me half of a dormant list was coming back. Dropped the intercept by 1.95 and the distribution landed where reality is. Second thing, and this one cost me an afternoon: the campaign simulator ran five independent Bernoulli trials, one per touch. That gives you 1 - prod(1-p_i), which is strictly below the sum. So the simulator was reporting 18 bookings while the ranking model it was built on projected 30. The simulator was disagreeing with the model it sits on top of. Fixed by drawing one uniform per patient against the model probability and then attributing the conversion to a touch by its share of the hazard. Lesson I keep relearning: when two parts of a system produce the same number by different routes, check that they agree. They usually do not, and the one that is wrong is the one you were not looking at. Every coefficient is visible in the product. If a practice manager wants to argue with why a patient scored a 12%, she can see the fifteen lines that produced it. A score you cannot argue with does not get used. ``` --- ## 5. Pricing and the ROI math Full detail in `PRICING.md`. Summary for the sales conversation: **$4,500 setup + $1,200/month per location.** Base case, 3-op practice, 1,600 lapsed patients: | Line | Value | |---|---| | Baseline blast reactivation | 3% | | Recall Engine, conservative | 12% | | Incremental patients recovered | 144 | | Year-one production per patient | $863 | | Gross production recovered | $124,272 | | Contribution at 38% margin | $47,223 | | Cost year one | -$18,900 | | **Net year one** | **+$28,323** | | ROI on spend | 1.5x | | Payback | 146 days | | **Break-even reactivation rate** | **6.6%** | The $863 is deliberately set below the median patient value in the demo cohort ($956). Quote conservative and beat it. **How to use the break-even number in the room:** say it out loud, early, unprompted. "Under 6.6% this loses you money." It reframes the entire conversation from "is he overselling" to "am I above the line", which is a question I can answer with their own export. --- ## 6. Top 3 objections ### "We already pay for Weave / RevenueWell / Solutionreach." > Keep them. Genuinely. Those are delivery tools and they are good at delivery, and I am not going to ask you to rip out something your team already knows. > > This sits in front of them. They answer "how do we send it." This answers "who is worth sending to, in what order, and what should it say." You are paying for a megaphone right now and pointing it at a list nobody has ever ranked. > > Here is the test. Pull your last reactivation campaign and tell me what percent of the full lapsed list booked. If it is over 8%, do not buy this, you have already solved it. Most practices are at 2-4% and have never actually measured it, which is its own answer. *The move: refuse to compete with the incumbent. Compete with the absence of ranking. And hand them a disqualifying test, because offering a real way to say no is what makes the yes credible.* --- ### "My front desk already does recall calls." > They do. And they call about forty people a month, because that is what fits between checking patients in. > > The question is not whether calls happen. It is whether those forty are the forty worth the most. Right now they are coming off a report sorted by date or by last name. In the cohort I work with, the top 31% of the list holds 70% of the recoverable value, so the difference between a ranked forty and an alphabetical forty is roughly four times the production for identical labor. > > The second half matters more to your team than to you. About a third of any lapsed list will never come back. Right now your front desk is spending real phone minutes discovering that one call at a time. This tells them up front who not to call, which is the part they will actually thank you for. *The move: never suggest the team is underperforming. Attack the sort order, not the people. Then close on making the front desk's day better, because the practice manager is in the room and is the one who has to adopt it.* --- ### "These patients left for a reason. Won't chasing them annoy people?" > Some did leave for a reason, and those are exactly the ones this suppresses. Moved out of the area, service complaint on the chart, never once responded to anything the practice sent: all scored down, none contacted. That is deliberate. Every message to somebody who is never coming back costs you an opt-out on a channel you need for somebody who would have said yes. > > But most of your lapsed list did not leave over anything. They changed jobs, had a scheduling conflict in March, meant to call back, and then eighteen months went by. Nobody is offended to hear from their dentist. They are mildly relieved somebody noticed. > > And the copy is per patient, not a blast. It references their actual last visit, their actual hygienist, their actual benefits. That does not read as marketing. It reads as your office keeping track. Your team approves every template before anything sends. *The move: agree with the objection first and show the product already implements their concern as a feature. The suppression list is the proof.* --- ## 7. First 10 prospect types and where to find them Ranked by expected close rate. **1. Practice that just hired an associate dentist** New chair capacity, no patient base attached to it. The owner is now paying a salary against production that does not exist yet. *Trigger:* job post filled, or an "welcome Dr. X to the team" announcement. *Where:* Indeed and ZipRecruiter for "associate dentist" in target metros, filtered to posts closed in the last 60 days. Practice Instagram and Facebook "welcome" posts. ADA Career Center. **2. Practice hiring a hygienist while running open hygiene columns** The tell that they are patient-short, not staff-short. Highest urgency of any signal. *Where:* Indeed "dental hygienist" posts open more than 45 days in one metro. Cross-reference against online booking: if same-week hygiene availability is wide open, they do not have a staffing problem. **3. Newly acquired practice, 3-18 months post-close** New owner inherited a list they have no relationship with. The dormant base is the only growth asset they own outright and it costs nothing to reactivate. *Where:* state dental board licensure change-of-ownership filings (public in most states). ADA transitions listings. Dental broker "recently sold" pages: Henry Schein PPT, Professional Transition Strategies, US Dental Transitions. **4. Practice that just switched PMS** Migration broke every recall automation and nobody rebuilt them. There is a 6-18 month hole in their outreach and they usually know it. *Where:* Dentrix/Open Dental/Curve user Facebook groups and r/Dentistry migration threads. Curve Dental and Open Dental publish customer announcements. **5. Two-to-four location owner-operated group** Enough scale to feel the dormant base as a real number, still small enough that one person signs. Best revenue-per-hour of any segment. *Where:* Apollo: Industry = Dentistry, Employees 20-100, Title = Owner/Practice Owner/CEO/Managing Partner. Filter to companies with 2+ locations. Enrich against Google Maps for verified location count. **6. FFS or hybrid practice in an affluent zip** Higher production per patient, so the same reactivation percentage is worth substantially more, and they are less numb to a price tag. *Where:* Google Maps scrape by metro, filter to practices that do not list "we accept most PPO plans." Cross-reference median household income by zip from Census ACS data. **7. Practice that recently cut Google Ads spend** Actively looking for cheaper patient acquisition. Reactivation is the cheapest channel they own. *Where:* SpyFu or SEMrush domain history showing paid spend dropping to zero in the last 90 days, across a list of practice domains built from Google Maps. **8. Solo dentist, 15+ years at one location** The largest dormant base in the entire market. Two decades of accumulated lapsed patients and no system that has ever touched them. *Where:* state dental board licensure data filtered by license issue date pre-2010, joined to a practice address that has not changed. ADA member directory. **9. Practice with a dedicated practice manager or treatment coordinator** Has somebody who can actually own the work list. Adoption risk drops enormously and retention roughly doubles. *Where:* LinkedIn Sales Navigator: Title = "Practice Manager" OR "Treatment Coordinator" OR "Office Manager", Industry = Hospital & Health Care, Company size 10-100, keyword "dental." Connect to the manager, sell to the owner. **10. Emerging DSO, 5-15 locations, still founder-run** Highest contract value in the list. Sells per location. Slower cycle, one champion, and a real reference if it lands. *Where:* Group Dentistry Now's emerging groups list. DEO (Dentist Entrepreneur Organization) member roster. ADSO associate members. LinkedIn: Title = Founder/CEO, keyword "dental group" or "DSO." --- **Sequencing note.** Types 1, 2 and 3 are event-driven and should be worked within 30 days of the trigger, which means they need a monitored list rather than a batch send. Types 5, 8 and 9 are stable and can be worked in bulk from Apollo year-round. Type 10 is a named-account list of maybe 60 targets nationally and should be worked by hand, not by sequence. **Channel note.** Owner-dentists are poor email responders during clinical hours and good ones after 6pm and on Fridays. Practice managers are the reverse. Send to owners in the evening.