Eliminate Cancellations? When donkey’s fly and hell freezes over maybe!
To quote one of my favorite dental guru’s, Howard Farran, “To eliminate cancellations and fails you might as well pick up the
earth and throw it into the sun”. I LOVE this! Everyone is looking for
the magic pill that will cure this ill of dental practices
I hate to be the bearer of bad news, but there is no magic pill, no quick fix, no one
system that is ever going to eliminate cancellations and no-shows.
None. The only thing you can do takes hard work; Have the best systems
in place, follow them consistently and be prepared with
a backup should a cancellation or no-show happen!! You know, that
never-ending Perpetual State of Preparedness that I always talk about!!
Here are a few things to consider when streamlining your systems to
make sure that your practice has everything in line to make the most of
the challenging opportunity a hole in the schedule provides:
Relationships – Does your practice just “schedule
appointments” or do you “build relationships”? Relationships WORK –
relationships are an avenue for two-way respect – If you are “just
scheduling appointments” the patients will have the mentality that “its
JUST a cleaning” – When your whole team works on building that
relationship with each patient, it becomes an educational opportunity
which will leave the patient desiring the treatment they need and
keeping their word with their appointments. Who wants to disappoint
someone else that they have a good, trust based relationship with? I
don’t want to disappoint someone or make them think I’m a schmuck! You
must create a value for them, a WIIFM (whats in it for me?) and
appreciate them keeping their appointments. Tell them “THANK YOU for
coming in today – we always enjoy seeing you and appreciate your time
and effort you are dedicating to your oral health”.
Information – Make sure that you have all updated
communication information for the patient – also find out which method
of communication (and number) they prefer to be reached at during the
hours of 8-5 – put this in the alert or patient information note box. I
cannot tell you how exasperating it is to try to confirm someone when
all 3 numbers on file are incorrect, or when you try a work number and
you get screamed at for calling them at work. Communication is KEY!
Confirmation system – When do you start calling? Do
you follow-up with electronic confirmations that are sent out? Do you
strive for 100% confirmations every day? Do you consistently do book
review watching for the habitual offenders and calling them a week in
advance? If you have tried multiple times to confirm an appointment,
left messages, sent emails/texts and you still haven’t heard from the
patient, do you give them one more call (day prior) and let them know if
they don’t confirm their appointment by noon today you will need to
remove their appointment from the schedule and have them call back at
their convenience to reschedule? At this point, they pretty much aren’t
coming, so get them off the schedule so you can get someone else on!!
Waiting with bated breath, crossed fingers and toes, hoping that a
patient is going to show up is NO way to run a practice.
Here’s what we see work well in other offices:
Expectations: Clearly define your expectations.
Everyone says “oh, don’t talk about cancelling or rescheduling – It
gives them ideas” (try using the words appointment adjustment in place
of cancellation – make it a positive!) Talk about that elephant in the
room! Lay out your expectations. This should begin with the new patient
information. You require 48 hours for appointment adjustments, SAY IT –
If you don’t receive the courtesy of a 48 hour notice, TELL THEM what
will happen. Period. How on earth can you expect them to meet your
expectations if you avoid telling them what your expectations are????
You say 2nd late appointment adjustment you’re getting a fee,
then do it. If you waive the fee, you make sure the patient knows what a
favor you are doing for them, THIS time only and mark their record
accordingly. Let them know how you confirm appointments, when you
confirm appointments and that you expect all reserved appointments to be
confirmed. Define it. Say it. Expect it. In return for their
cooperation, you will meet their expectations by appreciating their time
New Patient Reservation System – If you haven’t already, go check out Next Step Dental Resources New Patient Reservation System. We have used this ourselves in a few different offices and it works!! Stop those new patient no shows!!!
Pre-appointing – No one should leave your office
without their next appointment card. Ever. If they are going to have a
co-pay, go ahead and jot in down on the upper corner of the card. Don’t
make a grand gesture of it or hand it over to them and say “this is your
co-pay!!!!”- just do it. Hand them the card, let them know that’s the
estimate of their co-pay and jokingly remind them to put the card on
their fridge. Or better yet ask them if they would like to go ahead and
enter the appointment in their smart phone – you’ll wait while they do!
Reminder cards – 3-4 weeks prior to the
appointments, send out reminder cards. Not only reminder cards, but have
the verbiage on there asking the patient to call and verify their
appointment day/time (HIGHLIGHT this request!!) When the patients call
from the cards, you thank them for calling to verify, ask if they would
need a courtesy call a few days prior or if you can mark the appointment
confirmed now? If they need to reschedule, great, you now have weeks to
fill the hole. Don’t put anything negative on these cards like “we
require 48 hours notice for cancellations”…. They should already know
that, and we want this card to be positive! We are looking forward to
seeing you!! Also send out at the same time cards for patients who are
now due/past due for their recare visit inviting them to call to
Book review – among all the other opportunity you
are searching for when doing this, one week out look at the next two
week’s schedule. Habitual offenders should be *marked somehow – If there
is one on the schedule CALL THEM right away. If they don’t confirm one
week prior to their appointment, you leave the message that you’re
removing them from the schedule.
Electronic confirmations – Send them out one week
prior – call habitual offenders though immediately!– call anyone who
hasn’t confirmed 3 days prior to appointment if no electronic
confirmation. Why bother sending out electronic confirmations at all if
you are sending them out the day prior to the appointment. What good
does that do? If the patient cancels you have no time to fill it and
what if they are the type of patient that doesn’t check their email or
texts regularly? Whoopsie – they FORGOT! Set your electronic
confirmation system to send out reminders 2 business days PRIOR to the
appointment day. You’ll notice a huge difference! I want to have ample
time to fill those appointments with people waiting to get in. No more
Phone confirmations – Don’t be afraid to use every
number on file – If you must leave a message, we recommend that you
always state your name, where you are calling from, THEN ask them to
return your call at (office number) when they receive your message as
you need to obtain a confirmation for their upcoming reserved
appointment time – then right before you hang up, remind them again of
the “confirmation number” you need them to call. Again, day prior if
there is no confirmation you leave the “remove from schedule message”.
(important to state your phone number right after your introduction
because we find once they hear “dentist office” they don’t listen to the
rest of your message anyways!!)
Short call lists – Now, you are going to end up
removing some patients from the schedule. It’s going to happen. As long
as you are prepared to deal with it, then all is well. Having multiple,
viable short call lists to call from to help fill last-minute holes.
Here are 5 viable lists to actively work from in filling last minute appointment openings:
- People who want in sooner, or a more specific appointment
should be noted appropriately on the ASAP so you can find this
information with minimal searching/clicks – Every patient that is
scheduled out further than 2-3 weeks should be asked if they would like
to be contacted to come in sooner if their desired day/time opens up. Be
sure to record this on the appointment notes to be able to effectively
use this system!
- Use your phone log (you DO have one of these right?) You
know, the log that you write down all calls and messages? Great for
fills/follow-up and ensuring no patient gets “lost”!
- Unscheduled list – the list that has everyone’s appointments who have cancelled but not yet rescheduled? HINT*** every time
someone cancels an appointment, insert a dateline, include a note of
why they cancelled and when you will follow-up then “break” the
appointment – Be sure to check out our blog on the importance of NOTES –
you can never have too many! Check it out here – Everyday I’m shufflin’. NEVER delete unless they aren’t coming back to your office.
- Past due recare list
- Last but not least, pulling people forward from future dates
– look a week out to see who might be scheduled at the same day of the
week/time of the day – but of course be sure if they have insurance they
are within their covered time period.
Phone availability – You ever notice patients like
to leave messages to cancel? Usually on a day when you are out right? If
you are closed on Friday with only your answering machine/voice mail
greeting these callers, what do you walk into on Mondays? Or if you are
out on Wednesday, what does your Thursdays usually end up looking like?
Voice mail/answering machines don’t intercept cancellations, reschedule
(keeping them on the schedule somewhere!), schedule new patients or
anything else. Actually, they just make more work for you! You know,
that morning scramble of checking the voicemail and listening to 3 or 4
patients who need to cancel – the panic builds as you realize your
schedule just got blown to smithereenies….. Stop the madness!
If you start providing a minimum of 40 hours a week phone
availability along with non-interrupted schedule attention during that
time (Work it baby, work it!) you will notice an immediate positive impact on your production numbers. Ask me how I know.
Follow up – This is probably one of the most crucial
points on this list. Follow – up. With everything. That IS where the
fortune lies you know……… The fortune is in the follow-up my friends. What systems do you have in place for follow-up?
So here you have it. Donkey’s aren’t going to fly anytime soon but at
least you can put yourself in the Perpetual State of Preparedness and
protect your schedule!
Here’s to minimizing no shows/late cancels and protecting your schedule, production and time!