When a patient cancels an appointment, everyone loses. The doctor and team lose valuable chair-time and productivity, and most importantly, the patient loses because he/she doesn’t receive the treatment they need. Just two cancellations per day can cost a practice as much as $50,000.00 per year in lost revenue.
We assume that if we educate a patient about their health that they will make the right choices, follow through with treatment recommendations and show up for scheduled appointments. If this were true, then educated people would not smoke or be overweight. It takes more than education, it takes commitment to action.
If and when a patient calls to cancel, make a big deal out of it. Hear them out and then say “oh” and pause for a moment. Do not say “o.k.” and then reschedule for the next available time. Ask the patient, “Will you hold for a moment please while I get your chart?” or say “I need to need to speak with the doctor, will you hold for a moment please while I get your chart?”
Look at three things on the chart:
1. The patient’s condition
2. What is the treatment?
3. Why they are having it done?
Now you are armed with important and powerful information when you return to the telephone call. In the meantime, the patient has had time to understand how important the appointment is.
If the patient thinks that you have discussed this with the doctor, now it has become a big deal, and keeping the appointment will become much more important. No one wants to make the doctor mad.
“Tom, you are scheduled at 8:00 for a crown preparation. We have your crown back from the lab and we know how important this is to you – isn’t there any way you can make it?”
Make it hard for people to do what you don’t want them to do and easy to do what you want them to do. Don’t quote your office policy to patients because they don’t care. It’s all about “what’s in it for me?”
No Shows
What if the patient does not show up? The assistant should call the patient within first 5 minutes. Let the patient know that “we are all waiting for you.” This sends a strong message to the patient and it tells the patient that “you are important to us and we are on top of it.” Don’t ask the patient coordinator to call because if the patient is not in the chair, the assistant has time to call. If you simply send a letter, it won’t arrive until 3-4 days later, so how important was that appointment?
Confirmation Calls
Confirming appointments may sometimes present an opportunity for the patient to cancel. The word “confirm” implies that the appointment wasn’t firm in the first place and allows the patient an out. The same is true with reminder calls. If you are calling to remind the patient, it means that you are not expecting them to remember and it allows an escape route “Oops, I forgot.” Patients may develop a selective or elective memory.
Instead of a “confirmation” call try this:
I’m calling about your appointment with Dr. Smith tomorrow at 10:00 a.m. and just want you to know that we will have everything ready for you. We’re looking forward to seeing you. Will you call us if there is anything that we can do to make your appointment more comfortable?”
If you must leave a message on an answering machine, do not ask your patient to call you back to confirm. That adds another condition and opening for the patient to back out of the appointment.
Late Patients
Late patients will be seen only if the circumstances are such that it could not be avoided and it does not interfere with the next appointment. If a patient arrives too late, they should be re-appointed. Tell the patient that if half the appointment has been missed, you are not prepared to only do half of the job.
If a patient does not provide sufficient notice for a cancellation do not “reward” the patient by giving him/her a prime time appointment – re-schedule the appointment during your usual downtime or at a time that is less convenient for your patient. Otherwise, you are letting your patient know that it’s o.k. to cancel at short notice and there will be no consequence for their action. Your patients need to know that you will work with their schedule but you control yours
New Patients
Have you every wondered why new patients cancel? They are anonymous! You don’t know who they are and they don’t know you. To prevent new patients from canceling, the doctor should take 5 to 10 minutes each evening to call the new patients the night before the appointment to make an introduction and welcome the patient to the practice.
“Mrs. Jones, I’m Dr. Smith. I’m looking forward to meeting you tomorrow. Thank you for choosing my office. Is there anything that I can do, or my staff, to make your visit more comfortable?”
When the call is made, there is no more anonymity and it is the first step in building the relationship with the new patient. This not only surprises and delights the patient, but it sends a clear message that “you are important to me and I am committed to your care.”
If the patient shares information with the doctor, that information needs to be communicated back to the team so the team can follow through on the patient’s requests.
Dramatic changes can occur with just some minor changes in how you communicate with your patients. Try changing the way you handle cancellations for the next few weeks and monitor the results to see for yourself. Remember that the process involves more than just educating the patient, you must prompt your patient to take action and to be as fully committed to his or her own wellness as you are.
