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.
