Regarding Your Late and No Show Patients

1.   Reinforce when the appointment is made how important it is to show up and be on time. It is never "Just a quick check," or "Just a short appointment." They are all important appointments! Train new patients from the very beginning.

2.   Make a flyer about appointment keeping and put it on the desk. Hand one out with each appointment card. Mention how with " summer schedules" (or the start of school, or the New Year, whichever applies), we tend to get lax or forget; that all appointments are critical to the effectiveness of treatment and to the timeliness of completion. Ask for their cooperation. Ask for 24-hour notice of appointment changes. And tell them there is a $25 charge for each no show after three have been failed. Use your discretion in what is a just cause. (I think three is fair.) Then charge it!!! Warn in writing after no show # 1 and no show #2 (have post cards made up). Then send Card # 3 that says, "Ooooppps…you did it! It's now Number 3." And tell them they have been charged, then charge it. By warning verbally and in writing, you will get paid. But paid is not what you want-a breathing body in the chair is always preferable!

3.   When they do not show or call in late or just show up late, act surprised and concerned. Be glad they are OK. Reschedule the appointment, warn of the $25 fee on the third no show, and warn of treatment delay. If they are late, have them still come in to check for breakage and pokeys. Tell them you will see them but may not be able to complete the treatment planned for that day due to lack of time left.

4.   On the chart, be sure NS or LATE appears in red. Show the patient or parent each time and explain how it prolongs treatment. Each chart should include an Estimated Date of Completion (EDC) in red. If their EDC is June 2003 and they miss an appointment, change it to July. Show the patient each time the date has changed. Then they are the bad guy, not you. If you still manage to finish on time, then you are the good guy!

5.   See the patient if they are late, but do not do all you planned to unless the schedule allows it. That is, if someone else has cancelled or not showed or you are ahead of schedule. Never make other on time patients wait because someone else was late!!!

6.   Next month, when they are on time, reward them! Praise them and thank them! Give a certificate for being on time!!! You don't have to give a prize or money related item; the certificate is enough. Reward the behavior you want to create.

7.   Consider the Ooooppps coupon idea. At the start appointment, give three coupons that say only "Ooooppps!" that patients can redeem for breakages or no shows or being more than 20 minutes late (you decide the boundaries). After they are all used up, you charge for boo-boos.

8.   Dr. Duane Grummons actually writes each kid a $100 check and staples it to the back of the chart. He leaves it unsigned and tells them he will sign it and give it to them at the deband if they have no no shows all the way through treatment. With each no show or excessive breakage (ones that are not his fault), he subtracts $25 from the check. They get what is left. When you start this plan, all fees should go up by…guess how much?

9.   Most importantly, be fair and be firm, yet always diplomatic and kind. There is a fine line between the two. We have an efficient office to run, yet we are also understanding and empathetic to people's lives and situations and the stuff that gets in the way of their cooperation and compliance.

10.   With those for whom lateness and no shows are excessive, a mini consult should be scheduled. Sit down with patient and parent to discuss the situation and try to find remedies.