Make it easy: How to prevent dental patient no-shows before they happen

Feb. 12, 2015
If there has ever been a common lament of dental offices everywhere, it is openings in the hygiene schedules. I don’t think any practice is totally immune from the occasional no-show or last-minute cancellation.

By Andrea Kowalczyk, RDH, BS

If there has ever been a common lament of dental offices everywhere, it is openings in the hygiene schedules. I don’t think any practice is totally immune from the occasional no-show or last-minute cancellation. The advantages of a full hygiene schedule are obvious. A healthy revenue stream and patients getting the care they need are what we all strive for. Some of the negative consequences of slow schedules are subtler, but they affect dental practices in big ways.

The backup plan

Preventing no-shows before they happen is the best strategy. However, there are some steps you can take to fill unplanned open schedule time. Here is an “emergency backup plan” to refer to in the event of a no-show.

  • Time is of the essence — Call patients to remind them they’re late. Ask if they can come in now for an abbreviated appointment (exam without cleaning, for example). Ask if they can reschedule to another appointment time today.
  • Capture the “low hanging fruit” — Patients who are scheduled for periodontal scaling and root planing for a future date should be contacted and offered one of today’s openings. If the opening is less time than it will take to complete the scaling, address at least one quadrant. Why? Treating periodontal infections takes priority over preventive services. There are no six-month frequency limitations for scalings.
  • Short-call list — The practice should keep a current short-call list. Contact these patients and offer an appointment for today. Why? Patients on this list are often available last minute and have indicated they want to be seen anytime. The short-call list should be updated, legible, and have current contact numbers. Having one team member as the “owner” of the list ensures it will not be neglected.
  • Today’s patients — Check the schedule for new-patient exams with the doctor. Contact these individuals to offer them the opportunity to begin their hygiene treatment following their visit. If the hygienist typically sees new patients, offer patients who are in for a limited exam a complete exam with hygiene today. Check to see if any of the doctor’s current patients are due for their cleaning. As a bonus, this provides convenience for patients.

When hygienists and team members have too much downtime, it breeds a host of negative feelings and frustrations that permeate the practice, particularly if salaries are paid based on production numbers. Oftentimes team member conflict, staff turnover, and low morale can be traced directly back to slow schedules. When hygiene schedules are open, the doctor’s schedule will in turn be open, and then multiple providers are unproductive. To further compound the problem, a slow schedule today means a slow schedule tomorrow. When patients are not in the practice, they are not telling their friends and families about their great experience in the office. That means additional lost revenue that is hard to measure.

Many of us put great effort into getting the hygiene schedules full, only to have them fall apart at the last minute. In order to address that, we must understand the primary reasons that patients are no-shows in the first place. Here they are:

  • Patients lead tightly scheduled lives, and their plans often change minute to minute.
  • Patients may not see value in dental services, or they may not see their oral health as a priority.
  • Patients are reluctant to take time away from work, regardless of the economic climate.
  • Patients don’t know how much we appreciate their business.

At first glance, it may seem as if there is not much we can do about any of these factors, but there is actually a lot we can control in these areas. We simply need to adapt to our patients instead of assuming they will adapt to us. In today’s ultra-competitive marketplace, the days of patients bending to our policies are over.

Our first priority is to make it easy for our patients to do business with us. This includes being open during convenient or extended hours. We need to reach patients and allow them to reach us via text and email. We should immediately remedy any of their concerns about billing and fees, and provide solutions and options for payment.

We must keep a current short call list for patients whose plans change at the last minute, or who prefer to come on short notice. We need to welcome emergencies, and get as much treatment done in one visit as possible. We should take the time to educate patients and personalize treatment recommendations to their specific needs and wants, and use patient education videos, brochures, and websites. Help patients see how prevention can save them time and money.

Finally, even in this age of technology, patients need to feel an emotional connection to a practice, and know how much the team values serving them. Patients who feel appreciated are much less likely to fail an appointment.

When they arrive at the office, we can show patients we appreciate them by shaking their hands, using their names, and giving them our full attention. We should listen to their concerns and ask follow-up questions.

If you still have openings (see sidebar), check with restorative patients and new patients who may need whitening or sealants. If you still end up with downtime, use that time wisely. Work on the schedule first, not last. The schedule is the most important priority of every team member.

Trying to fill holes in a hygiene schedule at the last minute is a reactive way to do business, and a practice cannot thrive that way. When we take thoughtful, proactive steps to meet our patients where they are, instead of the other way around, our efforts are rewarded with full schedules and happy patients. What could be better than that?

Andrea Kowalczyk, RDH, BS, works as a senior hygiene performance coach with Enhanced Hygiene. She obtained a bachelor’s degree from O'Hehir University and a post-graduate certification in mentoring. She speaks nationally on hygiene topics, including on how hygienists can avoid career stagnation. She resides in Houston with her husband and son. She can be contacted at [email protected].