During a recent CEO Dentist Virtual Academy session, we explored practice profitability and the financial impact of having just one empty slot in the daily calendar. A big questions was, “Wes, how do I handle patients when they’re on the books for a 9AM appointment and they don’t call to cancel until 4PM the day before? Or worse, when they don’t even bother to show up?” Establishing your policy for late notice cancellations and no-shows and the process for communicating with your patients are an important aspect of dental practice management.
The only decent excuse a patient can give you for no-showing is that they’re dead. It might sound harsh, but I believe that when a patient no-shows or cancels at the last minute, they’re telling you that they don’t honor your relationship or their own health.
Establish a Formal / Written Cancellation Policy
An appointment is an agreement; a contract of sorts. Think about it. You keep your appointments. I keep my appointments. Why? It's a matter of commitment, trust, and mutual respect.
Put the conditions of your cancellation policy in writing and add it to your New Patient paperwork (financial policy, health and registration forms, etc.). Let patients know that you require 48-hours notice for an appointment change or cancellation and have them sign it!
“A” Patients Don’t Late-Cancel
If the patient has never been a problem before you might decide to let them slide. This is your call but understand that by letting them off the hook this time, you might be setting a bad precedent.
Also, just because this was the first time they were late with you, doesn’t mean it was the first time they were late [for their dental appointment at their previous office] or that they won’t be late again.
I’ve come to learn that people who are late once, tend to be chronically late; people who lie once, lie often; and folks who are snotty with one person, tend to be snotty with everyone. That’s just who they are and unfortunately, they don’t understand the consequences that their behavior has on the rest of the world.
You Have to Be Upfront with Patients About Their Behavior
When a patient is late for their appointment, the first thing you need to do is call (10-minutes after their scheduled appointment time). Start the conversation from a place of concern. Ask if they’re OK and remind them of when they were expected.
The patient will have a reason/excuse for not showing up. Listen to them. If they are not going to make their appointment and this is their first infraction or they’re new to the practice, give them the benefit of the doubt and just get them rescheduled.
If this is the second infraction, tell them you’d love to reschedule but do not offer a prime-time appointment. This patient belongs in the slot that you have the hardest time filling, not the lunchtime or after-work appointment. Those are reserved for your “A” patients.
A Few Options for the Repeat Offender
Once a patient has late cancelled or no-showed more than once, you can offer to put their name on a short call list and let them know when you have cancellations. You can ask that they pay a non-refundable advance deposit to secure the new appointment. Or, depending on how they respond to your concerns, you might come to the conclusion that this just isn’t a good fit.
We have a letter that we send out to patients at this point. It lets them know that they can be seen for the next 30 days for emergencies only and asks them to update the practice when they end up someplace new so that their records can be forwarded.
Not everyone is your perfect patient, and you deserve to work with people who value their health as much as you do.
If You’re Going To Make A Policy You Have To Stand By It
I don’t really care about a $50 cancellation fee. What I care about is that patients honor their commitment to their own health and that they respect my time. If that’s too difficult, then it isn’t a good fit and they can go spend that $50 somewhere else.
However, if you’re going to implement a strict cancellation/lateness policy then you have to stick to it. When my son first got his driver’s license I set his curfew at midnight. If he showed up at 12:01 and I didn't say anything, was there really a curfew? What was I telling him if there were no consequences?
It’s the same thing with your cancellation policy. You are training your patients. What message do you want to send?
Your word is your word. If you’re ready to stop tip-toeing around your patients and actually have a straight conversation, Contact Us. We can help you step into the role of CEO Dentist.
Do you have an effective policy to minimize/eliminate cancellations and no-shows? Leave a comment below.
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