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8.01.08 Issue #334 Forward This Newsletter To A Colleague

Another "No-Show"! Now What?
by Sally McKenzie CEO
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It is commonly cited as the number one practice frustration, the number one production killer, and the number one source of stress in dental offices around the country. Dental teams ask themselves daily what they can do to fix the problem. I suspect you know exactly what I’m referring to: cancellations and no-shows. Like Japanese beetles on a rosebush, these daily disturbances can chew through an otherwise perfectly manicured schedule in minutes.

Patient failures cost individual practices tens of thousands of dollars annually. Just two cancellations/no-shows a day, of an average value of $100–$125 each, can cost $40,000+ a year. That is at least one employee salary! Sadly, attempts to address the problem are typically met with either mixed or poor results.

Consequently, dental teams find themselves regularly working at the mercy of an unpredictable and ineffective schedule driven by the whims of unreliable patients who are either insensitive or unaware of the problems their short-notice cancellations and no-shows cause. Worse yet, oftentimes it’s a problem fueled by the team itself.

The fact is, most dental offices pave the way for patients to short-notice cancel or fail to show for their appointments. When a patient says he/she can’t make an appointment, the typical response is, “Oh, you can’t come in? Well, let’s get you rescheduled.” Cheap recall postcards routinely sent to patients state the time and date of the appointment and tell them what to do if they need to cancel, thereby planting the seeds for the patient to do just that.

Instead of coaching patients on how to avoid their appointments, teach them to value them instead. Reinforce that message in every interaction in the office, on the telephone, in every mailing and email, etc. Provide educational materials in the waiting room, at the appointment desk, in statements and in the hygiene and treatment rooms. Use informational on-hold programs to educate patients about oral health care each time they call your office. Every piece of mail sent to a patient should include some piece of information, such as a pamphlet on oral cancer or tooth whitening, or a copy of an article about a recent oral health study.

Next, pay attention to what you say when patients are in the chair. Comments that the doctor, hygienist and assistants make to patients today will have a huge impact on whether they keep their appointments in six months.

Create a sense of urgency. Doctors often leave patients with the impression that there is no hurry to pursue the recommended treatment. The doctor’s final words to the patient should stress the importance of proceeding with her/his recommendations.

The same holds true for routine oral hygiene visits. This is the opportunity for the hygienist to educate the patient and enhance patient perception by talking about the importance of systemic health, periodontal health and oral cancer. All of that increases the patient’s perceived value of routine care. If a periodontal co-examination is performed and the hygienist talks about the results and educates the patient—even a healthy one—he/she will have far greater appreciation and understanding when you must recommend another visit in four months rather than six.

In addition, consider providing a brief written summary of a patient’s visit. Rather than just sending patients away with nothing more than a yellow credit card receipt, include a hygiene appointment summary. This might provide a list of all of the procedures performed, such as a periodontal exam or an oral cancer exam, a brief review of the hygiene evaluation, home care instructions, a reminder about specific areas the patient may want to pay special attention to between now and the next visit, the doctor’s recommendation for follow-up treatment and a list of free products given to the patient along with their estimated value.

In many cases, this can be a standard template set up on the computer that allows the hygienist to fill in a couple of lines and click “print.” These documents can be waiting for patients at the desk when they pay their bills, or sent to them later via email. Patients will respond well to the summary because they typically don’t realize that the $100 appointment is much more than just a cleaning and exam.

Educated patients are far less likely to cancel and fail than patients who are not. They understand the need for and value their dental appointments and are far more likely to be in the chair at the designated time.

Next week, curb cancellations up front.

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