I very much enjoy the feedback we receive from all of you who read and enjoy my weekly e-Management newsletter. Here’s another office having trouble with how to deal with “late patients” and they responded with the below to let me know how much they appreciated the “Late Patient” article McKenzie Consultant Jean Gallienne wrote earlier this month in issue #500. If you missed the 500th issue, you can find it HERE.

Jean urges dental care providers to treat the patient with respect regardless of their timing, she writes:

“Go ahead and review the health history, and begin the appointment as if you would any – do blood pressure, ask the patient what problems, concerns, or changes they have. Once you have actually evaluated the patient’s mouth, this is the time to decide what will and will not be done during that appointment. Even if you have seen this patient for years and you know they have a trash mouth, at least look in the mouth.”

She goes on to say, “If the patient does have a concern, and if time permits, at least address their concern – get x-rays, and even probe if that is all you have time for, and reschedule them for the specific time required to complete the cleaning. … “You may also want to have Mrs. Smith stay in the office long enough to make sure the next patient is going to show.”

Sally…

Thank you for the article on the Late Patient…..this information is so needed, especially now…..everything you said was perfect…..it is the same way Dr. and I feel and now it is on black and white and comes from someone else other than the owners of a dental practice. We have had multiple employees who have disagreed with us and with what you have put in print. We have actually had to terminate staff for not taking care of their patients due to them arriving a little late. …staff who think this way usually are not on the same page with other office philosophies as well. There is much controversy in offices about this, especially with hygienists. I agree with you in that if you have the right team in place everything can still go smoothly at their appointments for these patients.… it does affect patient retention….you don’t want to tamper with patient retention in these days, especially if you practice where there is a lot of competition. Thank you…Thank you….Thank you for this article and for saving our practices.
Dr. E & C.E.

Sally,

I would like your best thoughts on the proverbial problem of last minute cancellations. What are your thoughts on how best to teach patients that which most could not know about the importance of showing for an appointment with the doctor? I believe we need to have knowledge and maybe with knowledge, some might be less comfortable canceling figuring the doc just then goes on to the next one. Do you believe it wise to equip them with the facts such as the room is set up for just them, this is time set aside just for them, no one is there to “fill” this time etc., obviously not worded exactly as said but for purposes to ask you. Is placing something on the Website or other such measures worth exploring? Thank you so very much for your experience and knowledge shared!
Best to you, I am grateful to you for your time and your care in helping those of us open to your best ideas.

Joann

Hi Joann,

Oh yes, the proverbial PIA last minute cancellations! Each time an appointment is made in person, I would put the appointment card on the counter and say, “Mrs. Jones, if you would confirm your appointment card, it should say that your next appointment is Tuesday March 6th at 3:00pm. You should expect to be here around 1 hour. If you are unable to keep this appointment, please send me an email or call here (point to appointment card) and we do respectfully request 2 days notice in order to give your reserved time to another patient.

If the patient is a “no show”, they should be called within 10 minutes of the appointed time. Assume something has happened to the patient instead of immediately reprimanding.
“Mrs. Jones? Is everything okay? We were expecting you for your appointment at 2:30.” At this point, you have to determine if there has been a pattern or if the patient is lying to you.
“Mrs. Jones, obviously we are having difficulty coordinating an appointment time that is convenient for you and for our office. I don’t have any available appointment times now but I will keep your information and give you a call.”

Your last minute cancellations were not specific as to what type. If they are pre-scheduled recall appointments 6 months ago, then this is the nature of the system. It is inherent in a high cancellation and failure of appointment rate and as a result may not be the best system for your practice.

Let me know if this was helpful.
Sally

Sally,

We have a huge number of patients that have had one of the PPO’s we are part of and now find themselves without insurance. (retired or unemployed or even new standard insurance) The problem we are having is that more and more patients are angry with us due to our fees. Patients with PPO’s have a much lower fee plan than that of our normal pay for service patients. Now without insurance they want us to still honor the fee of the PPO or they are leaving because we are so overpriced. We have not had this issue prior to the PPO and we just don’t know what to say to these patients. I looked at your archive and didn’t find anything directly referring to this. Thank you for any help/guidance you can give us.

Renee

Hi Renee,

There is no right or wrong answer here. Putting myself as the owner of the business, the business decisions I make have to be what is in the best interest of the business, always. In order to make an informed decision, I would want to know how many of my active patients were actually on this PPO plan and how many people it affected, i.e., retired and unemployed. I would then want to know how my fees ranked within the zip code for my practice. You can purchase this on my web-site here: http://www.mckenziemgmt.com/book-practice.htm#b11. From this, I should be able to tell if the patients are able to in fact, go to another dentist and that my fees might be too high. If I were to lose a lot of business then I might have to consider a “post PPO” courtesy adjustment. I would also need to work on lowering my overhead as much as possible in order to be profitable.

Hope this helps,

Sally