Your recall list is bigger than the report says it is
Run the overdue report in your practice software and you get a number. It is almost always lower than the real one.
This is not a criticism of the software. The default report answers a narrower question than the one you are asking, and the gap between those two questions is where a few hundred patients usually live.
Three groups the standard report misses
1. Patients with a future appointment they will not keep.
Most overdue reports exclude anyone with a scheduled appointment. Reasonable, except that a patient who booked eight months ago for a date next March, and who has already cancelled twice, is not an active patient. They are a lapsed patient with a placeholder.
Pull your list of appointments scheduled more than 90 days out, cross-reference against last visit date, and see how many have not been in for over a year.
2. Patients marked inactive or archived.
At some point someone tidied the database. Patients who had not been in for a few years got flagged inactive so they would stop cluttering reports.
They are still people who chose your practice once and still live nearby. Unless they moved away or asked to be removed, they belong on the list. Ask whoever maintains your software what the inactive flag actually filters, and how many records carry it.
3. Family members of active patients.
This one is easy to miss and easy to fix. A household where the parents come in every six months but the adult children stopped after college are three lapsed patients hiding behind one active account.
Search by address or by guarantor rather than by individual, and you will find them.
Why the number matters more than it looks
Because almost everything downstream scales off it.
Whether recall is worth outsourcing. Whether you qualify for a guarantee, most of which have a minimum list size. Ours needs 500 patients overdue twelve months or more, and plenty of practices that think they fall short actually clear it once these three groups are counted.
It also changes the arithmetic on advertising. If your real lapsed list is 700 rather than 400, the case for working it before spending on new patient ads gets stronger. That ordering question is worth settling early.
The context nobody mentions
The reason these lists get large is not that your practice is badly run. It is that most adults in the country are not seeing a dentist regularly.
The ADA’s Health Policy Institute found that in 2022, 40% of working-age adults had a dental visit in the past twelve months, against 52% of children. Three in five adults did not go. Some proportion of them are yours.
Nobody drifts away because of a single bad experience. They move house, change jobs, lose the insurance, mean to call back in the spring. Then four years pass.
What to do with the bigger number
Two cautions.
First, do not mail the entire list at once. A campaign to 700 people produces calls, and calls need someone to answer them. Work it in waves you can actually handle.
Second, clean as you go. Bad addresses and dead numbers are part of any old list, and the only way to find out which is to contact them. Mail is useful here precisely because an address decays more slowly than a mobile number. That is most of the argument for postcards.
And settle your definitions before you start counting anything, or next quarter’s number will not be comparable to this one. Here is what to pin down.
Start with two integers
Active patients, and patients with no visit in twelve months, after checking the three groups above.
If you want the value of that second number worked out with the assumptions printed on the page, the free report does it in about two minutes and asks for counts only.