HELP! WHAT SHALL I DO ABOUT BROKEN APPOINTMENTS???

One of the great annoyances for the dentist, for the dental team member(s) who handle scheduling, and for the hygienist in the case of Recare appointments, is broken (BA) appointments and cancelled-not-rescheduled (CA-NR) appointments.  Failed appointments plague many offices, costing time and money.  A system for processing BAs and CA-NRs is a necessary factor in effectively managing your practice.  The office that pays little to no attention to BAs and CA-NRs finds patient count dwindling and often wonders why.

A written protocol is an excellent training tool for new team members and a useful reminder for seasoned staff.  Unless a standard process is in place, BAs and CA-NRs get absorbed into the busy flow of a day’s patients and are soon forgotten.

Consider the following steps as you and your staff put your BA and CA-NR protocol in writing:

Enter into the computer, preferably the chairside computer in the treatment bay,  the treatment plan and the next appointment, including the next Recare  appointment, for every patient.  Doing so means that at the end of each month a  list of all BAs and CA-NRs can be generated and contacted for rescheduling.

Appoint each patient at today’s appointment for one subsequent restorative or  hygiene appointment.  Suggestion:  do not give a series of restorative  appointments.  If a series of restorative appointments is made, lay people- patients who have no idea that restorative work will be done in sequence often  think,  “It’s OK to break my next appointment with Dr. Jones because I have  another (others) already scheduled---not showing for one appointment won’t  matter.”

When a BA occurs, call within 10 to 15 minutes of the no-show.  Either a  business staff member, the dental assistant who was to work with that patient, or  the hygienist if a Recare appointment, can make the call.  A non-confrontational  way to inquire:  “We were worried about you, Mrs. Smith, when you didn’t come     for your 3PM confirmed appointment.  Dr. Jones asked that I call to make sure  there’s no problem.”  The staff member should then be quiet, allowing the patient  to explain.

Reappoint the patient as soon as possible if a BA is unusual for this patient.  If,  however, the patient has a repeated pattern of BAs, consider reappointing in four  to six weeks. This gives the subtle message that Dr. Jones’ office is so busy that  he cannot see that patient for several weeks.

Some practices choose to charge for a BA, informing patients of that fact when  the next appointment is made.  Others find doing so counterproductive and  annoying for patients.  These offices prefer to send an email or a note via USPS  mail to the patient who frequently breaks appointment with some version of this  message:  “While we do not currently charge for broken appointments, they are  very costly.  Dr. Jones and his assistant set aside special time to care for you;  and medicaments, instruments, and equipment are prepared, ready for your  treatment.  Additionally, another patient who could have used that appointment  time has been delayed.  We appreciate your choosing our office to meet your  dental needs, and we work diligently to give you the best dental care available in  a timely manner.  We respectfully request that you make every effort to keep all  appointments or call our office at least 24 hours prior to reschedule.  We will  be happy to reschedule your appointment for ________________.  Please call  our office today.” 

Note all BAs and CA-NRs in the patients’ chart, computerized or paper.  Call  these patients by the end of the month in an attempt to reschedule.

Inactivate those patients who simply cannot be reappointed within four to six  months.  Upon inactivation, notify the patient in writing via “Certified Mail, Return  Receipt Requested.”  This serves as important documentation should the patient  later claim “patient abandonment.”

Some combination of these factors can compose your standardized BA and CA-NR system.  The dentist and one or two experienced team members can write BA/CA-NR protocol to be shared with the entire team at a staff meeting and frequently thereafter.