If you want your patients to accept treatment, stop scaring them. Do not use the word recession anymore in your practice. Don't let your staff do it either. I've said it before, reacting to the recession negatively, will only make it more likely that your practice will be affected negatively. When recommending treatment, don't say, "Mrs. Jones, you need a crown. I know it's tough with the recession so we'll give you six months to pay with no interest." You don't know how Mrs. Jones is faring so why bring it up. Pretty presumptuous, actually. Instead, tell her what treatment she needs and let the ball land in her court. Now, if she says, "Oh, with this economy money's tight." then you can offer the six months to pay, but you still shouldn't mention the word recession. Just say, "You're a wonderful patient and I want you to have the treatment you need. I'm happy to have Mary set you up with a payment plan that fits your budget." All positive from you, no negative. Sounds different, doesn't it? I encourage payment plans rather than third party financing right now because patients are more wary than ever of anything resembling credit. They don't see a payment plan as credit and are more likely to accept it. In addition, it's seen as goodwill by patients. It's relationship building and keeps a steady cash flow coming into the office in a tough economy. Will some fail their plan? Possibly, but I think patients are being very realistic about what they can afford right now. They don't seem to be agreeing to amounts they can't meet, at least not in our practice. What about the patient who is in dire straits? They've lost their job and may be looking at selling their home? Believe me, you are way down on their list of priorities. So, you have choices. Do you badger them for money they don't have and send them to collection? Since you can't get blood from a turnip I prefer to react with compassion and patience. We're not going to get paid right now anyway, so why be a jerk about it? At the very least, it may lead to goodwill. At best, when things get better, you will probably get paid. Either way, you'll have been a decent human being. Try not to fire staff if you can help it. When a hygienist is let go, it is going to impact the amount of treatment that can be treatment planned, there's no doubt about it. Doing your own hygiene might sound like a good idea, but unless you are sitting with hours open on your schedule, you may just be getting caught in a vicious cycle and limiting your ability to rebound. Try putting the hygienist on commission or reducing a day rather than firing her altogether. Then, when things are better, increase her hours again. Do the same with other staff if you must. In the meantime, have your staff brainstorm ways to increase productivity. When someone has downtime, they should work on reactivation. If you are short staffed you can only survive, not thrive. I'm not saying to try to fool yourself that the economy isn't hurting, it is. I'm saying, be part of the recovery. Don't lay at the bottom of the financial pool and wait for the life to ebb out of your practice. Pull it up and breathe life back into it. By doing that, you not only help yourself, you help the economy overall, as well.