Most practices are sitting on six figures in easy revenue. The cash is already inside your walls, hiding in three places: unscheduled observation patients, no-shows, and unanswered calls. Run reports. Set simple targets. Work a consistent follow-up cadence. You’ll add new starts without chasing a single lead.

Observation isn’t a waiting room. It’s a relationship you actively nurture so the eventual “yes” feels effortless. These patients already like and trust you. Letting them drift is a quiet leak that costs you real money. If they don’t understand why they’re returning, you lose momentum. Build value in every touch and book the next appointment before they leave.

Think of observation patients as checks in your hand. You don’t have the money until you take it to the bank. Value between visits is what turns that check into cash at the consultation. Track your schedule rate on observation. If 80 percent or more of observation patients have a next appointment booked, you’re healthy. Under 80 percent? You have a pipeline problem to fix now. Close the two big loss paths fast: cancellations that never get rebooked and visits with no clear reason to return.

Most teams quit after one or two attempts. That’s where conversions die. For colder records, plan for consistency over weeks with multiple touchpoints, not a couple of polite calls. Use text first because it gets replies fastest. Layer calls for tone and personal connection. On reactivation days, give two touchpoints in the same day so your number registers, but don’t do that every day. For long-stale patients, expect fifteen to twenty total touchpoints across text, calls, email, and even postcards.

Day to day, the Treatment Coordinator should own the observation pipeline and know the numbers cold. The scheduling team supports outreach, and the doctor stays in the loop with regular reviews. Leadership should scan a simple set of KPIs weekly and get a monthly snapshot of total observation count and the percent not scheduled. This isn’t micromanaging. It’s accountability with help, praise, and clear goals. People respect what you inspect.

“Say it with a smile” isn’t a cliché. Patients hear your tone. Many callers have dental anxiety and need to feel seen and safe. Pre-frame the experience on the first call: same-day starts are possible, here’s what we’ll cover, and here’s what we need in advance. Capture personal notes that make the handoff to the TC seamless and human, including whether they’ve met the doctor before. These details raise confidence and reduce friction on arrival.

Track your answer rate and staff peak hours. Ten missed calls in a day can equal a five-figure leak. A single missed start-capable call each day adds up to roughly a million dollars over a year. Use call recording and VoIP reporting to spot busy windows and adjust coverage. Set a clear answer-rate goal and celebrate the behaviors that hit it.

Set the bar — Keep observation schedule rate at or above 80 percent. If you’re under that threshold, start working the list immediately.

Work freshest first — Segment your unscheduled observation list by last-seen date. Under twelve months responds faster, older records need more touchpoints.

Run the cadence — Text first. Add calls for warmth. On sprint days, use two touches in one day, then space out follow-ups. Expect fifteen to twenty total touches for long-stale charts.

Make it visible — Review a simple weekly report and a monthly snapshot. Praise specific wins. Offer help before problems snowball.

Pre-frame success — On new-patient calls, set same-day-start expectations, gather insurance in advance, and capture personal context for the TC handoff.

Protect the front door — Monitor answer rate, staff to peak volume, and use recorded calls for coaching. Aim high and celebrate progress.

Your observation column isn’t a pile of “not yets.” It’s a stack of uncashed checks. Build value at every visit, schedule the next one before they leave, and run a follow-up rhythm that matches how people communicate today. When you do, you turn quiet goodwill into reliable starts without buying a single new lead. That’s how you take the check to the bank.

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