Other than legitimate last minute issues, what causes patients to cancel without notice, or no-show altogether? What many practices don’t understand is that it is often the absence of ‘value’ placed on the appointment by the patient, leading them to believe “It’s no big deal, I can reschedule”, or “They’ll call me back if I really need the treatment.”

The end result: frustration for you and your team, and costly holes in what probably started out as a full and profitable schedule.

Let’s look at some ways to decrease cancellations and no-shows that are available for you and your team to use starting today.

Confirmation Calls

First, devise how the confirmation call should sound. Practice making these calls at a team meeting, making sure to cover:

• How to answer patient questions or concerns.
• How to address patient questions regarding financing.
• What treatment will be done at the appointment.
• How much time the patient should expect to be in the office.

Important: Avoid telling the patient they should call if they are unable to keep the appointment or that you need 24-48 hours notice to cancel. Why are you giving them permission to cancel? Don’t put the idea in their head!

Practice the confirmation call, which should sound similar to this:

“Mrs. Smith, this is Amy from Dr. Eagle’s office. Dr. Eagle is looking forward to seeing you tomorrow, Thursday, April 7th at 2 p.m. for your (description of treatment). We expect it to take about an hour, and we look forward to seeing you then.”

Or…

“Mrs. Smith, Rebecca, your Hygienist, is looking forward to your appointment on Friday, April 8th, at 10 am for (description of treatment). It should take about 30 minutes, and we’re all excited to hear about your recent trip to Europe. See you then, have a great day.”

Remember to record the conversation in the patient chart, electronic or paper. In fact, all conversations/left messages should be recorded in the chart – date, time, reason for the call, result of the call, and follow up with the patient if necessary. Your computer software has an area to record these contacts and to create a memo to appear on specified date to follow up if you do not hear from the patient.

Other methods to decrease no show/missed appointments

1. Send reminder emails, text messages and voicemails. (Even to those patients who say, “Don’t call, I always remember.”)
2. Use services like Smile Reminders, Televox and Demandforce to aid in confirmations.
3. Make sure you’re getting the most out of what services your software provides you.

Use the Power of Peace-of-Mind
Help your patients make healthy choices and play their part by scheduling and keeping their appointments! A happy and positive outcome with treatment is always a two-way street. Remind your patients that if they want to keep their protection plan (warranty) active, they need to keep up with hygiene visits as prescribed. This way, you can ensure the treatment you’ve done is in good working order, and your patients are taking care of their smiles and health.

What to do before the patient leaves the office

If patients leave without scheduling an appointment for recommended necessary care, make a note of why they are not scheduling. For example, patients may say they need to check their schedule, or talk to their spouse. Follow up with patients, create a memo in your software as a reminder to call and speak to them in 5-7 days. If you don’t follow up with the patient, they believe the treatment is no important, time goes by and the patient is lost.

Make best use of schedule changes

When making an appointment, ask your patient, “If we have a change in the schedule and can see you sooner, may I give you a call?” This is an efficient way of filling holes in the schedule. Inform the patient you are putting them on your VIP, or short call, list. Ask the best way to reach them in the event you have a change in your schedule and make note of it on the appointment. When there is a change in the schedule (we never have cancellations), you can call the patient and say, “I have good news. I promised to let you know if we had a change in the schedule and could see you sooner. We can see you today!”

If a patient does have a scheduling challenge and needs to change their appointment, don’t immediately deactivate them or label them as “bad patients”, and do not immediately give them an appointment for tomorrow. Your first priority is to see how you can help them keep their appointment for today. If they are unable to re-arrange, find an available time slot for the treatment and suggest you put them on your VIP list, find out best way to reach them should you have a change in your schedule.

Patients will have legitimate reasons to request a change in their appointment. First, know their past behavior before attempting to schedule/reschedule them. Something urgent might have come up that made them cancel or miss their appointment. Many professionals make the mistake of thinking, “Why bother? If the patient wanted his dentistry done, he would be here.” Boxes of charts representing lost patients continue to pile up in storage. Rather than throwing up your hands in frustration, tackle those charts. What if each member of your team contacted just one or two lost patients every day? Most dental insurance values a patient at $1000 per year, but of course the true value can be much, much more. Or, they can be worth zero if they are ‘lost’.

Call patients for the “right” reasons

Don’t call patients just because the doctor told you to call, or because there are holes in the schedule. Call patients because you are concerned. Call because you care. Patients need to know you care about them and not their money.

Deal with the limitations of insurance covered care  

While you do not want to limit treatment based on a patient’s insurance coverage, it is important to help patients understand the limitations of their insurance, and to present affordable treatment options to them. If necessary, negotiate with them. Warn them about the possible dental loss that could occur if they do not proceed, and how that dental loss could lead to additional expense. If they do schedule, avoid ‘buyer’s remorse’ by sending them a letter stating how you look forward to seeing them at their next appointment – especially new patients. Be assumptive. Act as if the patient is proceeding with the recommended care. Make sure the wording and phrases used are positive.

What to say when patients delay treatment

When patients want to delay treatment, tell them their dental condition could get worse and more expensive. Then document your warning by having the patient sign a delay in treatment form. Often, when the patient is expected to sign a form stating they are declining treatment, what the possible consequences will be and that they will not hold the doctor responsible, they schedule! Follow your practice protocol to follow up with patients who do not proceed with necessary dental care, along with procedures for ending your legal responsibility for them.

As an incentive to schedule and follow through with future appointments, follow up with patients after treatment. Have the Doctor/Assistant/Hygienist call patients post-op to check on how they are feeling, especially after difficult appointments. Prepare a short script for the team if needed.

Cancellations and no shows are inevitable, but their effect can be minimized by applying these simple rules and guidelines.