Do your patients keep their appointments?

Last minute cancellations and no shows is one of the biggest frustrations in a dental practice. These scheduling problems can wreck your entire day. You may have the perfect day scheduled with the right mix of procedures and, at the last minute, someone calls and cancels, or even worse, they do not show up for their appointment. Many practices that are struggling with last minute cancellations and no shows start charging a cancellation fee as a first step to correcting this problem. That is one of the biggest mistakes you can make.

If you’re experiencing a high volume of last minute cancellations and no shows, that is a sign of a problem with how you’re communicating value, and how you’re communicating the expectation for the next appointment. If you’re communicating effectively this should be a very small isolated problem that happens every now and then in your practice. However, if this is a major issue in your practice, and the very first thing you do is start charging patients  a changed appointment fee, you are going to cause patients to become frustrated.  They may even leave your practice because they feel the fee isn’t fair. So, what can you do?

First, evaluate what you say each and every time you schedule an appointment. Are you building value and are you communicating the expectation of what you want your patients to do if their schedule changes and they can’t keep an appointment? What’s OK and what’s not OK?  Effective communication can be as simple as saying: Mr. Patient, I’m reserving an hour on my schedule for you next week and, because we are reserving this time just for you, we ask that you give us a minimum of 24 hours notice if you need to make a change. In this example you’re 1) letting them know that you reserved the time just for them, and 2) you’ve given them the steps to take if something changes. This protects your schedule by giving you time to fill a canceled appointment and creates awareness in your patient of the value of the practice's time. For a more advanced procedure – one that takes longer than an hour – you want to be sure that your cancellation policy is generous enough that you don't lose a whole morning to a last minute cancellation or no show. In this case you want to let the patient know that you’ve reserved your entire morning for him and, should he need to make a change, you need at least 48 hours notice. You could even say a week. Make sure that whatever your expectation is you communicate it in a way that the patient clearly understands it.

Patients don’t want to break the rules. It has been my experience that this communication improvement alone will decrease the level of last minute cancellations and no shows in your practice. 

The other thing I want you to take into consideration is whether you demonstrate that you value your patients’ time. It’s not fair to ask your patients to value your time if you’re not valuing their time in return. You must be very careful about when and how often you move a patient’s appointment. Let’s say, for example, you want to rearrange your schedule to make room for golf tomorrow afternoon. Do not call all of your patients and say: "Doctor has something that’s come up and we need to move your appointment." Or, "We have a sick team member and we need to reschedule." If this happens every now and then that's understandable. Just like if they ocassionally have to miss or reschedule an appointment, we can understand that. But, if you make a habit of moving patient appointments, you’re going to send the message that when something comes up we just simply change the appointment. You must honor your patients' time as much as you’re asking them to honor yours.

If you put these strategies in place, you’re going to naturally reduce the number of last minute cancellations and no shows. Then for those patients who abuse your policies, you can add the cancellation fee as the final element to this system.