‘Backfill’ Your Cancellations and No-Shows
“Doctor, Mr. Jackson just cancelled his prep appointment for those three crowns. He said he had something come up.” Poof. In less than 30 seconds there goes your production for the day, swallowed into that now gaping two-hour hole in your schedule. Every dentist in every practice experiences the seemingly endless frustrations associated with patient cancellations and no-shows. Broken appointments cost practices tens of thousands of dollars every year.
Have you considered just how much cash is siphoned from your practice in 10 minutes here and 10 minutes there of unfilled chair time? Let’s say your daily production goal is $3,500 or $437.50 per hour for an eight-hour day. Each 10-minute unit is valued at $73. Now you may feel that your schedule is pretty stable. On average, you may have a 30-minute opening in the morning and one in the afternoon. These might be the result of a cancellation, no-show, or a few open units here or there on any given day. In one month, working four days per week, your practice lost $7,008 and more than $80,000 for the year. Feel free to take a moment to catch your breath.
Now stifle the urge to call your business team in and demand that they do better. Rather, turn the mirror on yourself for a moment. Curbing cancellations and no-shows begins chairside. The schedule often depends on the clinical team’s ability to emphasize the value of the dental care provided during even the most “regular” dental visit as well as clearly explain to patients the importance of keeping their appointments.
Ironically, dentists frequently overlook the significant influence that they have on the patient’s perception of routine dental care. In a rush to return to their own patient, they often unwittingly minimize the value of care.
Consider this common scenario: The hygienist spends time explaining to Mrs. Patient that she is now showing signs of periodontal disease and may require more frequent oral hygiene appointments. The patient is concerned and is prepared to schedule oral hygiene visits once every four months. Then the doctor walks in to check Mrs. Patient. He comments on the “good job” she is doing with her oral healthcare. The doctor thinks he’s just being friendly, yet he has unintentionally given Mrs. Patient justification to skip her next oral hygiene appointment. “The doctor said I’m doing a great job; why would I book another appointment so soon?” Even more troubling, the doctor’s comments cause the patient to question both the doctor’s and the hygienist’s diagnostic abilities.
First and foremost, clinical teams must be on the same page. This situation is easily addressed if the hygienist takes just a moment to explain to the doctor what has been found and subsequently discussed with that patient. It is a simple solution, but it underscores the importance of the clinical team’s role in emphasizing the value of ongoing dental care.
If your practice is not stressing the importance of the next visit – be it for follow-up treatment or the next hygiene appointment – while the patient is sitting in the chair, you probably have many more broken appointments and cancellations than you should. In fact, it has been estimated that more than a quarter of your patients, about 28%, routinely cancel appointments largely because practices are not actively educating patients on the importance of keeping them.
In addition, avoid the tendency to schedule all appointments for larger treatment plans. Certainly, there is a strong desire to immediately schedule the patient for all necessary visits, as if that will guarantee they keep every appointment. However, booking the entire treatment plan does nothing to ensure the patient won’t change or cancel appointments. What it does do is cause the schedule to appear unnecessarily full and overwhelming. Simply avoiding the tendency to overbook patients will help reduce the number of cancellations and no-shows the practice has to routinely manage.
Finally, be patient with your patients and educate them. Oftentimes, they have no comprehension of the turbulence that their “little” cancellation or no-show can cause you and your team. They do not set out to create havoc or disruption in your day. They too are very busy and when something has to give in their demanding lives, it is often their personal appointments. However, educating them on the necessity and value of ongoing dental care is an essential step every practice can take in controlling cancellations and no-shows.
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