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Belle DuCharme CDPMA
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To Pre-Appoint Hygiene or Not?
By Belle DuCharme, CDPMA

To pre-appoint hygiene or not? Ahh, if only it was that simple to have a black and white answer to a question that carries so much gray matter. Assuming that you have laid the ground work with great verbal skills and value-building of practice services, and assuming you have a philosophy of patient care that includes not having patients wait more than ten minutes for their appointment, and assuming that you and your staff promote total health and “walk the walk” not just “talk the talk” - then pre-appointing every patient is a good idea. Did I say that?

What about new patients that call in for an appointment? They want to be seen usually within a week or two on the outside. Since practices spend thousands to attract new patients, giving them what they want when they call is paramount to building a thriving practice. “We are booked out six weeks for a new patient hygiene appointment,” the business coordinator whispers apologetically as she scans the tightly filled hygiene schedules. “We can put you on our wait list. All of our patients pre-appoint but sometimes they call in to change their appointments because things come up. When that happens I will call you to get you in. Is that okay?”

Or, how about scaling and root planing appointments, can they be scheduled in a timely manner? Your diligent hygienist is diagnosing periodontal conditions that have an urgency to appoint attached to them and to the dismay of the hygienist, the business coordinator says, “Oh, we can get you in six weeks from now”, or “I don’t have a two hour block of time for several weeks, let me see what I can do to get you in. Lets put you in here and if anything opens before this, I will give you a call.” Does this convey value or importance? 

Okay, you say you need to add more hygiene days, but what about the average one or two daily cancelled or broken hygiene appointments? These were pre-appointed hygiene appointments that now are open to fill. If we get on the phone and frantically call everyone that has agreed to be moved up, then we should be able to fill those spots, right? Having to pay a hygienist to call unscheduled recall is counter-productive, so the business staff drops what they are doing to make these important outbound calls.

All practices are unique to their demographics, psychographics, philosophy, training and skills. Insurance driven practices that pre-appoint will hear this with a cancellation: “My insurance changed at the first of the year and you are no longer a provider on my list, sorry, I forgot to call to cancel my appointment.”  Or, “Sorry, I still owe you money from last year so I am canceling my appointment.” Or, “I don’t recall making that appointment; my work schedule has changed so I cannot come in.” You are going to get cancellations and no-shows with pre-appointing, but it is far more successful to pre-appoint most than to pre-appoint none.

I would not pre-appoint those that have a track record of last minute cancellations or failures, those that are having difficulty paying their bill (unless they have agreed to pay for the hygiene appointment and continue to make payments on their existing bill), those that balk at making a future appointment, and those that are patients only because of the insurance. You will have far fewer broken or cancelled appointments from patients who value their appointment and understand the connection between good health and regular professional dental care. 

When pre-appointing, take into consideration the new patients that want to come in and the patients diagnosed with scaling and root planing.  My advice would be to not schedule all openings several weeks out, as that will eliminate your opportunity to see new patients and patients needing scaling and root planing. Hold or block times strategically throughout the schedule for new patients and scaling and root planing, and if these appointments are not booked two days before the time, then call patients that are open to being moved and unscheduled patients to fill the times. This will prevent new patients from canceling and going to another practice that can see them sooner.

So, the question was - do we pre-appoint hygiene or not? The answer is a qualified yes and a qualified no, depending on your practice and its uniqueness. Want to build your practice and establish a successful recall system? Call McKenzie Management today and get the advantage with trained consultants.

If you would like more information on McKenzie Management’sTraining Programs  to improve the performance of your team, email training@mckenziemgmt.com

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