2 steps to controlling cancellations in your dental practice

There seems to be a common complaint when I go into offices these days - patients are cancelling the same day, or not giving the 24-hour notice that the office asks the patients to give. I typically follow up by asking if they are able to reschedule the patient and I usually hear, “Yes, we try to get the patient back in as soon as possible.” However, upon further examination, I’m discovering that patients are getting another appointment the next day or later that week. It’s time for a bit of “re-training” of the patients. This means that your patients need to understand that the doctor’s and hygienist’s schedule is valuable, and this can be accomplished by following a few important steps.

Step 1

It begins when a patient calls to cancel his or her appointment. I find that there is not a real effort to save the appointment. I have found that the best way to save an appointment is to pause and then, with concern in your voice, say:

“Oh gosh, is there any way you can make this appointment? The doctor set aside this time just for you and was really looking forward to seeing you this morning/afternoon.”

By having concern in your voice, you let patients know that you are looking out for them by trying to save this appointment. You might remind them about your cancellation policy (in the event that there is a policy in place). If there is a fee that will be charged, it is advisable to have your patients know about this policy by giving them a copy of the cancellation policy and also retaining a copy in their chart.

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Step 2

The second important step is determining when to schedule the patient. Often the team member will move the patients just a day or two out. This lets patients know that it’s no problem to call last minute to cancel because they’ll be able to get back on your schedule in a couple of days if something “better” pops up in their schedule. This prevents your patients from realizing that the doctor’s time is precious to the office, and to other patients as well. In turn, if the doctor’s schedule is full, there are no appointments available in the near future.

Re-training your patients begins with the way that you respond to the cancellation call. If the patient is not able to make the appointment, then the standing rule is to push him or her out six weeks, regardless of the next available appointment. Even if tomorrow is wide open, six weeks is the rule for the next available appointment time otherwise you encourage the patient’s behavior to cancel last minute. If you want your patients to respect the doctor’s time, you need to respect the doctor’s time as well. The conversation will go something like this:

“I’m so sorry that you can’t make today’s appointment. Dr. Molar’s/Mary’s (the hygienist’s) next available appointment is _________.” (State a date six weeks out)

“What? I can’t wait that long; or my deductible is be due again by then; or I was hoping to have the work done before my daughter’s wedding/my vacation/before school started.”

“Oh, I understand your dilemma, and that is why I was hoping you could make today’s appointment.”

This will be a wake-up call to the patient that your time is valuable. When patients are baffled at the wait to get on the doctor’s schedule, let them know you can put them on the ASAP list and call them if there is a change in your schedule. The hardest part is to not yield to their demands that they need to come in sooner and that is just too far out. If they are trying to get you to find something earlier, let them know that they can still come in for their original appointment but this is the next one available. Many times, they will find a way to keep the original appointment. Other times, the patient may seem to get mad so it is important to remember that they are the ones who have chosen not to keep the appointment that they scheduled.

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Once they have scheduled a new appointment and you have put them on the ASAP list, you can always call the patient back in a couple of hours and let them know about the opening in next week’s schedule or whenever you do have an earlier time available. You might say something like:

“Mrs. Jones, I know that you were really wanting to come in sooner than ____________, and I wanted to let you know that Mary has a change in her schedule for next Tuesday at 10:30 a.m. Would you like for me to reserve that appointment for you?”

Nine times out of 10, patients will appreciate that you were looking out for them and more than likely take the earlier appointment.

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This re-training will take some time to sink in for patients to start respecting your schedule, but I have seen this method work first-hand! I have witnessed offices go from having two to eight patients cancel/no show to having virtually no last-minute cancellations. The hardest part is getting the admin team to stick with the rule. After all, they see a hole in the schedule and want to fill it.

There are exceptions to every rule, like a patient’s family member getting hurt, a car accident, and the patient coming down with the flu or some other contagious illness that no one wants spread around the office. You know your patients. You know which ones cancel for honest reasons, and which ones cancel because they don’t feel like it, don’t want to come in, or something more fun came up in their schedule.

Always ask patients why they need to cancel their appointment and make sure to document it in their chart and/or on that appointment. Documenting their cancellations will help you to better understand if it’s habitual or a true emergency. It should go without saying to always be respectful and never condescending to the patient. Be sympathetic and understanding, while also being firm and respecting your schedule. It’s your schedule

Editor's Note: Photo is "Livorno Via Mancini 2" by Piergiuliano Chesi - Own work. Licensed under Public domain via Wikimedia Commons.