Last updated on September 26th, 2018 at 01:18 pm
In the practice of dentistry, one of the more annoying things that can happen on any given day is the missed appointment. And while a cancellation is slightly better than a no-show (at least they called, right?), itâ€™s still lost productionâ€”a hole in the scheduleâ€”and if it happens often enough, a hole in everyoneâ€™s morale. Too much of this over a period of time can make it no fun to go to work!
And by no means is this a small problem. Entire industries have sprung up in the past ten years to manage your schedule and confirmations, etc., i.e. sending patients automatic text messages and email reminders. Iâ€™ve met doctors who have hired and designated a staff member to do nothing but confirm appointments! Hygienists and assistants are asked to confirm patients during down time. All of this attention, energy and resources to get someone to show up for an appointment that will help them keep their teeth for the rest of their lives.
And it gets worseâ€¦
While many Iâ€™ve spoken with see a degree of improvement with various services, software(s) and confirmation call, emails, texts, and so on â€“ THEY STILL HAVE CANCELLATIONS AND NO-SHOWS. If I were to estimate, at least half of the doctors I speak with who employ one or more of these solutions are STILL looking for improvement in this area!
So, Whatâ€™s the Actual Problem?
First off, I do believe in confirmation calls or reminders. But, letâ€™s look at something:
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If a patient forgets about an appointment time or needs reminding, then the confirmation call, text or email is really will (most likely) prevent a cancellation or no-show.
BUT what percentage of cancellations and no-shows actually fall into this category (forgetfulness)? Not much.
In my experience, the largest percentage of patients who cancel or no-show have one thing in common: THEY ARE NOT â€śSOLDâ€ť ON THEIR TREATMENT!
What Iâ€™ve observed (and experienced) that supports this idea is that PATIENTS WHO PREPAY FOR THEIR TREATMENT PLANS ARE USUALLY THE LEAST APT TO CANCEL OR NO SHOW!
It was for lack of a better term, life-changing when my patients began to pay to reserve their time in my book; THEY SHOWED UP!!! Paying in advance improved their memory, had their car start in the winter and their kids didnâ€™t get tummy aches! It became crystal clear that scheduling a patient, confirming them and crossing my fingers in hopes that they showed up could all be replaced with the simple administrative action of having the customer pay for the product before receiving it. Kind of like Starbucks, season tickets for a football team, or getting a seat on an airplane!
If Starbucks didnâ€™t ask customers to pay before they get their drinks, they would be forced to hire a security guard to stand at the door to prevent people from grabbing the drink and running out without paying. More payroll, less profit. All because they didnâ€™t ask people to pay.
Iâ€™ve heard arguments against this idea in dentistry: â€śItâ€™s unprofessional,â€ť â€śIt will damage your reputation,â€ť â€śItâ€™s just not done in dentistry,â€ť â€śItâ€™s not fair to compare dentistry to a real business.â€ť Iâ€™ve heard it all. And Iâ€™ve tried it all. And what works best is to treat the patients with professionalism and ask them to pay for their products and services just like any other vendor they use.
It would be wonderful if we all practiced in a dental utopia where everyone showed up on time and insurance didnâ€™t â€śloseâ€ť claim forms or ask for X-rays. Unfortunately, we practice in the real world. Patients have their own day-to-day challenges. We need to help them get the health careÂ they need while running a business that expands, hires more people and provides quality care that will extend their lives. Itâ€™s a very satisfying profession; but it can become very frustrating if sound business principles arenâ€™t known and followed.
What About Hygiene Appointments?
Does this mean that I had patients pre-pay for the next hygiene visit? Nope. Personally, I think that sounds kind of weird. I know thatâ€™s how I would feel if someone asked me to do that.
So I tried something else. I would frequently look the patient in the eye and say,
â€śIâ€™m unwilling to do this crown if you arenâ€™t going to come back every six months and let me check to make sure that everything is OK with it.â€ť
Or how about this on a large case that needs perio therapy prior to restoring the teeth:
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â€śWe are going to help you get your gums in shape over the next four visits. Then after I restore the teeth Iâ€™m going to need to see you every three months to stay on top of the gum disease. I need that agreement from you before Iâ€™m willing to proceed.â€ť
This lets the patient know that you arenâ€™t joking about coming back regularly for maintenance and checkups. If the doctor thinks itâ€™s that important then the patient will too. Pretty simple.
The key to all of this is having the skill of talking to the patients and helping them understand the importance of maintaining their oral health while holding your position as a doctor. This is a very fine line to walk and if not done properly can actually backfire on you. Unfortunately we arenâ€™t taught how to do this in dental school.
My advice is to come to MGE and do the MGE Sales and Communication Seminars. We can teach you how to confidently talk to patients and gain their agreement to comprehensive care. Itâ€™s a win-win for you and your patients and you wonâ€™t believe how satisfying the practice of dentistry can be when patients are doing what the doctor says; not just doing what the insurance allows.