You Wanna What?

Hi – this is Mr. Jones. I have an appointment scheduled next week, Thursday I think, that I need to cancel. I don’t have any more insurance left this year and it’s just a cleaning anyways so I am going to wait until after the new year”

“Hello! This is Mrs. George. Last time I was in, Deborah the hygienist told me she wanted to see me every 3 months. I don’t even know why. My insurance will only cover cleanings 2x a year so I need to reschedule my appointment that’s coming up next week.”

“Hi. This is Tom Williams. I have an appointment next week and I want to know what it’s for. I ONLY want a cleaning – I don’t need to worry about the exam or x rays or anything else – nothing’s bothering me”

Do any of these sound familiar? I bet they do to your front desk team!

We’re thinking “You wanna what!!? Cancel your appointment for tomorrow after I’ve called for the past 3 days to get you to confirm!? Seriously??!!”

Ugh we say! Are you kiddin’ me? For crying out loud! Again? Oh my gosh, how am I going to fill those 3 hygiene holes before lunch?  We can get frustrated as it is our responsibility to keep that schedule full!

(Watch the below video I created – just for fun and a few laughs!!)


It happens. It happens a lot. It’s how you are prepared to handle it that is going to change the outcome.

When your team receives a call like this do they say “OK”, cancel the appointment and move on? Do they keep the patient on the schedule somewhere? Do they try to educate the patient on keeping the appointment? Do they take a brief minute to discuss with the patient the possible results from their decision?

For the front desk team to be completely prepared to handle these situations a few things need to happen consistently:

There must be detailed clinical notes on:

  • What was recommended
  • What time frame was given to complete the recommendation
  • Why it was recommended
  • Repercussions of not following said recommendations

When all of this valuable information is recorded and the front desk team uses this tool for success they can overcome these challenges by addressing each individual patients situation.

Hi – this is Mr. Jones. I have an appointment scheduled next week, Thursday I think, that I need to cancel. I don’t have any more insurance left this year and it’s just a cleaning anyways so I am going to wait until after the new year”

“Well hello Mr. Jones! It’s so nice to hear from you! (Buy time as you are pulling up the patients clinical chart and confirming appointment day/time) Yes, we do have an hour reserved just for you with Sally (the hygienist) on Thursday, October 28th. I see that your insurance plan dictates your benefit for 2 cleanings a year and that you’ve had to have quite a bit of restorative care this year which puts you at a high caries risk. With your permission, may I put you on hold for just a moment? (place patient on hold) Come back after an appropriate amount of time “Mr. Jones, I just went and shared your concerns with Dr. and he strongly urges you to keep your risk assessment appointment. The bacteria levels in your mouth need to be consistently monitored until you’re at a low risk level. We want to avoid any further restorations if possible and even waiting 2 months can really make a difference – We certainly understand your financial concerns – You’re portion of this visit will only be $ _____ – What other questions do you have for me? 

Of course, this verbiage needs to be made your own – I personally hate “scripting”.  Yes, we must all speak the same language but when someone is reading from a script, it’s not only evident to the patient, but it does nothing to encourage the engagement and connections we must make to build trust and beneficial relationships.

I cringe anytime I hear a team member tell a patient who wants to cancel “Oh, that’s ok. Call us when you’re ready”. Say WHAT??!!!

First, let’s quit calling them “cancellations”. That is an easy out. We don’t have cancellations – we have appointment adjustments. Remove the negative and replace it with a positive.

Do you have a clear appointment adjustment policy in your office? And one that patients are actually aware of?

If you don’t, please work on initiating this into your practice this week.

This policy should be included with the financial policy that you share with new  patients. It should clearly outline your expectations  in regards to all appointment adjustments and in turn also outline that you understand THEIR time expectations and how much you value them.

  • Require 48 hours notice for any appointment adjustment.
  • Collect a deposit for all treatment appointments scheduled (minimal is fine, but when you do this is places VALUE on this appointment!)
  • Consider looking into Next Step Dental Resource’s New Patient Reservation System – I can guarantee you that you will be ecstatic that you did! (One of my OH clients had 18 new patients NO show’s in July. They got on board with the New Patient Reservation System and in August, their new patient no shows were ZERO!!! )
  • Confirm all unconfirmed appointments two business days prior to the appointment.
  •  If you must leave a message, leave the office phone number and let the patient know that you NEED them to return your call to confirm their reserved appointment.
  • If you have left 4 messages and the patient doesn’t return the call, give them one last message that states if you don’t hear from them today by 2pm to confirm their appointment you will remove their appointment from the schedule and ask that they call back at their convenience to reschedule. Why keep someone on the schedule and  wait with bated breath hoping on a wing and a prayer that they are going to show? Take charge of the schedule and fill it with someone who wants the appointment and be PREPARED for what your schedule truly holds. YOU run the schedule.
  • If a patient adjusts their appointment, appropriate appointment notes MUST be made to ensure appropriate patient communication and that the patient doesn’t get lost in the system. The notes should include a dateline, who you spoke with, the circumstances of the appointment adjustment, and the appropriate follow-up date. I always ask “With your permission, may I follow-up with you in 2 weeks?” and note that I have their permission. The more notes you have, you increase your opportunity of reappointing.  Check out the blog WHEN DONKEYS FLY for more valuable information!
  • Unless someone is adjusting their appointment due to death or illness, never say its OK to adjust the appointment. When you use the confirmation system above and take control of your schedule by adjusting the appointments that patients don’t confirm, you rarely run into this situation. And even if you do, you can be prepared by using all of your short call lists to fill the opening! (ASAP list, unscheduled list, voicemail message log, past due recare list, undone treatment list)
  • When doing book review, take note of any patients that are habitual offenders. You know, the ones that make your stomach knot when you see their name on the schedule? Those ones. Call them NOW. Even if their appointment is in two weeks. Call them to confirm NOW. If they confirm, tell them you’ll be contacting them again a few days prior with a courtesy reminder. If they fuss, explain that they have missed X number of appointments and you can certainly mark it confirmed now, but if they would like a courtesy reminder you would be GLAD to do provide that as if they miss another appointment a fee would be assessed. Quit dancing around the issue and make your expectations known. You can do it in a nice way, a kind way, but if you don’t throw it out there, you’ll keep getting the same results. (I see some practices who charge a $50 reservation fee for hygiene appointments for chronic offenders… And these patients call to schedule an appointment and OFFER their credit card info to GET an appointment!!)
  • I have also heard voicemail messages that state clearly they do NOT accept appointment adjustments via voicemail and that the patient must call back during business hours to discuss their appointment to avoid a fee – and if they MUST cancel for an emergency reason, they can feel free to contact the DDS directly on his cell phone. 

Take control of your schedule. Today. Be proactive every single day in the efforts of keeping the schedule full. Allow for your expectations to be clearly defined.

Here’s to no more holes in your schedule. Look at it this way. Even an appointment adjustment is an opportunity. It’s all in how you look at it!

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