Making the uncancelable appointment

April 1, 2006
Our Client Services team gets calls daily from dentists and staff seeking “the magic solution” to cancellations and no-shows.

Our Client Services team gets calls daily from dentists and staff seeking “the magic solution” to cancellations and no-shows. Average cancellation rates for doctor and hygienist appointments have been estimated to be as high as 30 percent. A cancellation fee has not cured the “disease” that infects patients with thoughts such as: “I’m not that committed,” or “I really don’t like being here, so I’m going to skip my appointment.”

Psychologists estimate that almost everyone suffers some form of post-traumatic stress related to the dental visit. This doesn’t mean that going to your office conjures up a patient’s war memories, but it does conjure up experiences in which the person feels out of control. Let’s face it, many dental patients feel like bugs on their backs with their mouths open. How many times in a person’s life will he or she be unable to swallow, communicate, or sometimes even breathe easily? When patients get a rubber dam and cotton wads stuffed in their mouths so they can barely swallow - and at the same time get a lecture on the benefits of flossing - it is stressful, a fact we tend to underestimate. Psychologists tell us that people must feel in control of their situation. If they don’t, they will aggressively or passive-aggressively find ways to regain control.

Most patients choose the passive-aggressive route. They agree to treatment while in the chair, but react later by being tardy with payments, arriving late, or missing appointments altogether. The solution lies in discovering what you can do to make patients feel they are listened to, in control, and, above all, having their needs met. Here are some steps to accomplish that:

Give the patient choices. From the first customer interaction, offer options and ask for the patient’s agreement, rather than assume you have it. For example, explain: “Our philosophy is to partner with our patients to keep them in good oral health for a lifetime. Is this something you’d be interested in?” When setting an appointment or a financial arrangement, provide alternatives: “We have an appointment available Thursday at 10 a.m. or Monday at 9 a.m. Which do you prefer?” or “Payments could be due on the first or the 10th of the month. Which works better for you?” This makes patients feel as if they are being consulted.

Use a co-diagnostic approach. The new-patient experience needs to be co-diagnostic. If you explain, for example, the purpose of the perio probe and the meaning of pocket depths, then call out those depths as you measure them, patients get the facts when you do and have the knowledge to draw conclusions for themselves. This is much more persuasive than having your conclusions imposed upon them after an exam they didn’t understand firsthand. Co-diagnosing results in patients knowing what needs to be done and why, and then being committed to treatment before you present it.

Address the patient’s motivators and concerns. To influence patients to embrace treatment, address their motivators and concerns, and provide a solution to their chief complaint. If a patient’s chief complaint is that she wants a better smile for her wedding in six months and you suggest she wear braces for the next 18 months, you can expect resistance. Challenge yourself to tie in your treatment plan for healthy teeth and an improved smile for a lifetime with the patient’s long-term oral-health goals, and also address her more immediate needs for the wedding.

React quickly. When a patient cancels, notice it. Call immediately and focus on meeting the patient’s - not the practice’s - needs. Say, for example: “We missed you today for your crown prep. Since you told us you definitely wanted to save this tooth, we’re concerned about what obstacles got in your way.”

The sooner you build a relationship in which patients feel listened to and communicated with to get their needs met, the sooner you will significantly reduce cancellations and no-shows. We have demonstrated repeatedly that a five to 10 percent cancellation/no-show rate is achievable based on the health of the relationship. It may not be easy or quick, but it is the magic solution.

Amy Morgan is CEO and lead trainer of Pride Institute, the practice-management firm that helps dentists better their lives by mastering the business side of their practices. For more information on Pride’s seminars, management study programs, products, or to ask Amy a question for this column, call (800) 925-2600 or visit

Sponsored Recommendations

Clinical Study: OraCare Reduced Probing Depths 4450% Better than Brushing Alone

Good oral hygiene is essential to preserving gum health. In this study the improvements seen were statistically superior at reducing pocket depth than brushing alone (control ...

Clincial Study: OraCare Proven to Improve Gingival Health by 604% in just a 6 Week Period

A new clinical study reveals how OraCare showed improvement in the whole mouth as bleeding, plaque reduction, interproximal sites, and probing depths were all evaluated. All areas...

Chlorine Dioxide Efficacy Against Pathogens and How it Compares to Chlorhexidine

Explore our library of studies to learn about the historical application of chlorine dioxide, efficacy against pathogens, how it compares to chlorhexidine and more.

Enhancing Your Practice Growth with Chairside Milling

When practice growth and predictability matter...Get more output with less input discover chairside milling.