When donkeys fly!

Eliminate Cancellations? When donkey’s fly and hell freezes over maybe!

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To quote one of my favorite dental guru’s, Howard Farran, (www.DentalTown.com) “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 everywhere…………

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”.

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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!

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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.

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Here’s what we have seen 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 as well.

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 schedule NOW!

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 hygiene holes!

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!

MB

 “If you like getting what you are getting, keep doing what you are doing!”

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It’s time to replace that boring, non-productive answering service with a result producing, appointment scheduling AWESOME service!

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9 Responses to When donkeys fly!

  1. davidmadow says:

    This is a fantastic article!!! Thanks Mary Beth!

  2. Joe Bulger says:

    Terrific post MB… I learned early on (the hard way) that accepting and accommodating were bad words when it came to cancellations. Accommodating someone is easy, training them takes skill. People need to be trained how to be good patients with clear boundaries and expectations.

  3. Stumbled across your blog when I searched the office’s Facebook friends. Go figure. Wish I had seen it sooner! Very good information. Printing it out and bringing it to the morning huddle 🙂

  4. Mary Kay Milewski says:

    thanks for a very well written blog post..I too am sharing it with my staff.

  5. Worthy of re-posting! Thanks for the great info MB!

  6. Thank you!

    At Gorczyca Orthodontics, we charge for no shows. Otherwise, half our patients from the High School next door who come to apoointments without their parents would end up at Burger King and never make it to their orthodontic appointment! We charge $35 No Show without 24 hours notice. Once we started charging this, we never had a probloem with No Shows again. We usually give a patient one “Pass” but charge the second time after having documented that we repeated and reviewed our policy personally with them.

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