CANCELLATIONS
Cancellations and no-showsrepresent a major income detractor and source of excessive stress in most offices. The prevailing question is how do we keep cancellations to a minimum? Of course there is no one universal answer to this problem, since it is impossible to eliminate all cancellations. We can however influence the extent of cancellations through effective strategies and persuasive communication skills. I have found that offices that approach “cancellation control” as a team effort experience significantly fewer cancellations than typical offices. Here’s an example how each team member can help control the problem.
DOCTORS: During your treatment conferences, spend a few moments introducing the concept of “keeping all appointments as scheduled” to prevent treatment problems. Express your concern that once treatment begins, certain aspects of their treatment are started in one appointment and completed during a subsequent appointment. Stress that limiting undue delays between appointments assures for a smooth delivery of care. Your message becomes the seed for all future motivational techniques to limit cancellations and no-shows. Always thank the patient for making each appointment and reinforce their benefit of keeping to the treatment plan as scheduled.
DENTAL ASSISTANTS: After each appointment, explain to the patient what treatment was completed, and what treatment the doctor has planned for their next appointment. Emphasize the critical importance of their next appointment in relationship to the ultimate success of the entire treatment plan.
HYGIENISTS: In most situations, patients cancel appointment because of the diminished importance or priority they have placed on the reserved time. When arranging for the patient’s next continuing care (recall) appointment, communicate to the patient a specific diagnostic reason for returning. The reason should extend beyond the typical preventive cleaning and examination. EXAMPLE: “Bruce, we will need to see you in January, right after you sleep off your hangover from your New Years party. Not only will we professional clean and exam your teeth, but since there was a significant amount of inflammation and redness today we will need to re-evaluate the gum tissue on the lower right to make sure it does not progress.”
BUSINESS AND RECEPTION STAFF: You may be the last line of defense against cancellations. Confirming appointments is important, but does not always eliminate changes in schedule. Every experienced appointment book controller knows that it is important to let the patient feel as though they chose their best appointment time. That is why using “choices” is a very effective communication technique. EXAMPLE: “Bruce, do you prefer morning or afternoon appointments? Doctor can see you next Tuesday at 9 am or next Friday at 11 am, which do you prefer?” When the patient chooses one of your choices, you remained in control of the offered times and the patient feels as though they decided the best time for themselves. There is usually more commitment to keeping an appointment if one feels they “chose” the time themselves verses having to flex to your time needs.
There are very few phrases that I recommend to use verbatim, but this is one of them. When a patient attempts to cancel an appointment without an appropriate reason, use the following phrase. “Bruce, Doctor reserved that time especially for you to complete your crown, I know he would not want you to miss this appointment -- is there any way possible that you can arrange your schedule to keep this appointment?” Not only does this phrase help influence people not cancel, but it plants a firm message for the future that cancellations are not really acceptable.
BOTTOM-LINE: People are going to cancel. Why??? FEAR of dental procedures creates a “flight” response in many individuals. MONEY, or lack thereof creates significant enough embarrassment for many people to make up excuses for not keeping an appointment (the dog ate my homework syndrome). IRRESPONSIBILITYis a personality trait that results in lack of respect for other people’s time and effort. And finally, STUFF HAPPENS! People get called out of town, get sick, get lost, or simply forget.
Because we know that people cancel because of FEAR, we need to become more astute in identifying dental phobic's through more sensitive communications and enhanced listening skills. We also need to take more deliberate action in making definitive FINANCIAL arrangements before treatment begins. IRRESPONSIBILITY is hard to cure, but we can put a “stop order” on habitual cancellation and failure patients. Establish a definitive policy regarding how many time a patient can last minute cancel or no-show before you take action. I recommend that you use a technique similar to that used by the airlines. Require that abusers “pre-pay” for their planned treatment appointments before another appointment can be made. Explain that if they make their appointment as planned, the fee will already be paid for. If they fail the appointment, or do not give adequate notice, they will sacrifice their pre-paid fee to cover the office’s lost time. This may not be acceptable to some patients, but in many situations, you would be better served by losing these patients.
Because STUFF HAPPENS, go with the flow. Don't get stressed out or over anxious about things you cannot control at the moment. Use the newly acquired time to your benefit. Catch up with administrative work, return phone calls, complete staff members dentistry, train staff in new clinical techniques, read your Lowy’s E-Tips, or simply call your mother. Making something positive out of a potential negative is what winners are all about. Be winner and limit cancellations through a team effort. When cancellations do show their ugly heads don't let them ruin your day -- make the best possible us of your time.
