Get Rid Of Your #1 Frustration

How to banish no-shows and last-minute-cancellations from your schedule, forever!

by Mike Farley

If a Genie was to appear and give Dentists and their staffs the opportunity to make a wish and eliminate the #1 cause of stress, anxiety and frustration within their Dental practices -- I wonder what that wish would be?

I suspect the elimination of "last minute cancellations" and "no shows" (LMC/NS) -- if not their #1 choice -- would be very high on their list. LMC/NS's are like the weather -- everybody talks about it but no one does anything about it.

Why we don't address it

I think a Dental practice's unwillingness to firmly address this problem stems from both practical and emotional factors -- some of which are:

1. A lack of understanding on the part of the Team as to the tremendous financial cost to the practice when LMC/NS's occur.

2. A desire to believe the patient's excuse -- when studies indicate that up to 80% of the excuses are not true.

3. A desire to give the patient "one more chance" -- even though that patient has blatantly shown a lack of respect for our time.

4. A fear of terminating the patient -- and continuing to suggest that "we are just on the verge of making a good patient out of him/her."

So, if you are really serious about eliminating this problem from your practice -- then this is what I suggest . . .You should understand what the actual cost is to you when a patient is a LMC/NS.

The Lost Profit

1. Doctor Production

   If the production goal for Doctor is $300 per hour -- then 10 open hours per month due to LMC/NS would equal lost revenue of $3,000. (Often, even if that lost appointment time is filled, the dollar value of the LMC/NS appointment was much greater than the dollar value of the "fill-in" appointment.)

2. Hygiene Production

   If the production goal for a Hygienist is $100 per hour -- then 10 open hours per month due to LMC/NS would equal lost revenue of $1,000.

   Keep in mind that, in this example, lost revenue of $4,000 per month would probably have reduced monthly profit by approximately $3,000 because profit is much higher on the last dollars you produce each month than it is on the first dollars of monthly production. Assuming you could eliminate 75% of these LMC/NS appointments, your increased profit would be $27,000 per year!

3. Increased Overhead

   Another way of focusing on the cost of LMC/NS is to calculate your actual overhead cost per hour. For example:

   Assume that an office has actual overhead (not including the Dentist's salary) of $30,000 per month and that the office averages 128 hours of patient contact per month. Then the actual overhead cost would be $234 per hour. Or, in the previous example, 10 open hours per month due to LMC/NS would have an actual cost to the office of $2,340. (And you're trying to offset this by charging a LMC/NS fee 0f $35 -- which is usually waived! As Santa would say -- Ho, Ho, Ho!)

The Solution

Once you have fully digested the financial and stress-related costs that LMC/NS's are to your practice you should be ready to take the following steps (changes; behavioral modifications: etc.):

1. New Patient Discussion

   Doctor should make the following 45-second verbal presentation to all new patients:

   "Jason, we are delighted to have you in our Dental practice. We have the staff, equipment and knowledge to assist you in maintaining your maximum dental health. In return, we have one favor to ask of you. Honor your commitment to keep your appointments. 'Last minute cancellations' and 'no shows' are the biggest problems in a dental practice because they do not allow us enough time to schedule other patients who would like an earlier appointment. So, right now, let's agree that you will be the best patient we have -- and that, in return, we will be totally committed to your dental needs."

   This type of face-to-face conversation will, in most cases, solidify the patient's understanding of the importance of keeping his appointment.

2. Letter to Patients

   The following letter should be sent to your patients:

   TO OUR VALUED PATIENTS,

   The purpose of this letter is to share with you our concern regarding the biggest problem encountered by our dental practice.

   Although this letter may not pertain to you, we feel it is important to communicate this with all of our patients.

   Very simply, the problem is "no shows" and "last minute cancellations" of appointments.

   As you might expect, this not only creates a large amount of stress for us, but also necessitates assigning a valuable staff member to "put the schedule back together." This usually involves about three "person hours" per day and, of course, drives up the cost of dentistry. A missed appointment, without at least 24 hours advance notification, does not allow us enough time to schedule patients who would like an earlier appointment.

   In order to eliminate this problem we would ask your help in the following two ways:

   1. Honor your commitment to keep your appointment.

   2. When it is absolutely necessary to reschedule an appointment -- please give us at least 24 hours advance notification.

      Thank you for your understanding in this matter.

      -- Doctor & Team

3. Confirm All Appointments

   Confirm all appointments two working days in advance. (Note: For all patients who have previously been a LMC/NS -- the confirmation process must go one step farther. The message left for them must indicate that an acknowledgment call from them confirming the appointment is necessary -- or you will assume they won't be keeping the appointment and that they want us to give the appointment time to someone else.)

4. Establish a LMC/NS Policy

   Adopt this strict policy regarding LMC/NS:

   1. First LMC/NS: Give them the benefit of the doubt. Waive the LMC/NS fee -- and, again, stress that this is appointment time you have reserved especially for them.

   2. Second LMC/NS: Terminate the patient! This patient is obviously someone who doesn't care about the problems he/she creates for you. (Obviously, you will make some individual exceptions to this rule. However, it is important to set a policy and make exceptions, rather than allowing the exception to be the policy.)

Although these steps may appear to be stern -- you and your staff will be delighted when 75% of the LMC/NS problems disappear. Be courageous -- and do this! You'll be glad you did.