A little Dentists rant

If you make an appointment with me, especially as a new patient and even more so when its you AND your spouse, PLEASE SHOW THE F UP!

Time is money for me, this is how I not only support myself but also my staff.  When you don't show up, or call a few hours before your appointment to cancel it, you've just cost me money!  I have a 2 hour hole in my schedule today and a 2 hour hole in my hygienists schedule today because two new patients didn't show up.  When we called them when they were a little late for their appointment we found out they were "sick". 

Please, please please call several days ahead of time to cancel/reschedule your appointment.  Please, please, please just show up for your appointment!  Make it on a day/time you *know* you'll be able to show up!

Thanks

Your friendly neighborhood Dentist

I'll show up, provided that when I make an appointment at 1pm, you see me before 3pm.  I have to take time off work to see you and sitting and waiting for 2 hours is not cool.  And how come I need at least 48 hours to cancel an appointment, but you can call to reschedule me the day before?  It took a lot to rearrange my schedule and I've had this on the calendar for 6 months. 

Your friendly neighborhood patient. 

Reminds of the Seinfeld episode where he doesn't cancel 24 hours before and gets charged for the appt, but then the PT cancels while he is on the way there, and no return compensation. 

I can set my watch by my hygienist.

One of my other doctors, not so much. I recently drove the Porsche to that appointment. As I'm sitting there, it's getting darker and darker outside. So I asked the receptionist if I could "step out" for a few. So I drove home, swapped cars, and still sat there waiting upon my return. 

I came here expecting this...

In reply to pinchvalve :

100%.  I run a concierge style practice.  I rarely, if ever, run late.  I respect your time as I hope you respect mine.  On the rare instances that I do run late, my front desk staff lets you know and I'm maybe 10 minutes late.

I've NEVER run an hour or more late. 

David, the only reason you'd leave my office to go home and swap cars is because you want to show me your other car so we can geek out over it!

Many businesses have to deal with people and appointments. Can you improve your appointment confirmation and 'wait list' strategies?

• Maybe having the receptionist call each morning (maybe 30 minutes of work for 8-16 appointments)? Much less work if you only have to call new patients and patients who have 'missed' an appt in the past. That means you also need to have a system to track who misses and who doesn't. 
• Maybe ask your patients (specifically, retired ones) if they would like to be on a 'short notice discount list' where if you get a last minute opening in the two weeks preceding their appointment and they can make it you give them 10 or 15% off? That would build you an almost instant and large waiting list to fill gaps. 
• Can you get a system that uses text messages to automate the appointment confirmation and filling in from the waitlist process? I know they exist...

Seems you could turn this pain into a huge boon for your business if you act on it. 

My dentist text messages the day before, the morning of, and half hour prior to appointments, and the morning of one if I don't reply that I am coming they call me. My wife missed an appointment and she was only allowed to schedule an appointment for the end of the day until she had made it to two appointments.  

They run a tight ship on the hygienists; if one has you scheduled for an hour at the half hour point they know if they are going to finish or need a second session,  and they are done doing what they are going to do by the 45 minute mark.  At that point the Dr. gets you for @10 minutes and schedules any work and you are out the door by the hour.  

It's actually an interesting exercise in scale. I think they have 6-7 rooms, 4-5 hygienists working all the time and one Dr. Rotating through them while another Dr or two is working repair or real work with help off in another area. 

I do have an automated system that texts 2 days before as well as 2 hours before.  We call 7 minutes into the appointment if the person hasn't shown up yet.  Maddeningly many of the people who don't show up have confirmed their appointment thru my automated system.  Argh!

I like the idea of calling new patients the morning of their appointment.  Since they're new patients and not registered into my computer yet the automated recall system doesn't work for them.   

The short notice discount wait list is something that also is a good idea, thanks Robbie!

My guy mails a card and then calls me.  I get it.  

We send a card 1 month ahead of time that the patient addresses to themselves. That way hopefully they don’t throw it away without looking at it.

then we call them.  This is if they don’t schedule their next appointment before they leave, which we highly encourage 

My dentist canceled my appointment a few weeks ago because he was sick.

I love the text messaging system.  Since I am reminded, I'm never late for an appt, and I don't accidently schedule meetings on top of my appt.  My dentist runs like a well oiled machine.  I always make my appt. 8:00.  I get there at 7:59, I am seated in the chair by ~8:02 at the latest, and I'm usually out from a cleaning between 8:26 and 8:28am.  

Being this predictable has immense value to me as I am sure it does to them, so I respect it and am always on time.

My only complaint about my dentist is the cost. Root canals do not come cheap. 

My wife's veterinary practice is running with a waiting list for appointments, and as almost all the other vets in the area are dying or retiring, she's still getting plenty of potential new clients calling.

Under the assumption that some new clients might be better than some of the existing ones in her portfolio, she's willing to make appointments for them, but the no-show rate was getting so bad for new clients, she's had to start taking credit cards over the phone to hold an appointment.

It was about all she could do to keep her staff from just declaring "no new clients" as when they get a sudden open slot they go into a lot of urgent effort to fill the slot with someone from the waiting list.

Now, the preferable solution would be to add another doctor and more staff, but finding anyone willing to live/work in rural Iowa is proving to be pretty dicey.

I'd expect this in the Minor Rant thread.

Like it was said, if my appointment is for 1:00, I damn well better be in the chair by 1:00:30, because it takes me 20 seconds to walk down the hall and 10 seconds to get my glasses stowed and get in the chair.

 

docwyte said:

In reply to pinchvalve :

David, the only reason you'd leave my office to go home and swap cars is because you want to show me your other car so we can geek out over it!

When I was a kid, our dentist office was an old house converted to a business and the exam room had a window overseeing the parking lot. Whenever we had an appointment, my mom would have to drive my dads beater work car in the hopes of keeping the price down. 

I worked about 1/2 mile from my dentist where I lived before. The dentist was also a customer at my business. When it was time for routine cleanings etc. I'd tell them  "Just call me when you get a no show"  worked perfect for them. I could be there in less than 5 minutes.

As long as it's clearly stated up front, couldn't you include a no show fee in your standard charges?   Hotels do this all the time for people who don't show up for reservations.

In reply to docwyte :

In my elderly absent mindedness, I once totally missed a dentist appointment.  I offered to pay, but they wouldn’t take it.  I have been going there for 30 years though.  

I schedule all my appointments for first thing in the morning and they are always on time.   The only time my dentist has spent an hour wih me is when he is doing a crown.   On the standard visits, its less than two minutes.     

Mine is generally on time and calls me in the weeks and days leading up to the appointment with reminders to the point that it gets annoying. I put it in my phone's calendar the same time we scheduled the appointment, one reminder is plenty.

In reply to stuart in mn :

So, issue with that is with new patients, I haven't collected any payment info from them yet.  So there's no way for me to charge them.  I could try and send them a statement, but that would just get ignored.

I may have to start asking for a credit card # to hold the appointment and telling them if they don't show up we will charge a no show fee.

I hate to do that tho, I'm in a very saturated market and I'm trying to remove the barriers of entry so I can attract more new patients and grow my practice.

In all fairness, my dentist is awesome and never makes me wait more than a little bit. Hey, some people run long, I get it.  He is the one and only doctor I have been with for many, many years.  The rest are so bad, I keep switching in search of a decent one.  In fact, he has only canceled one appointment, my very first one, because his office and the entire town flooded.  So I make sure that I am there on time and if I can't make my or my kid's appointment unexpectedly, we pay the fee with a smile.  (maybe once) 

Due to the privacy act, the appointment reminder system has been rendered useless.  We get voice-mail messages like this: "This is your doctor's office calling to remind you that a member of your household has an appointment this week. If you can't make it, please call us".   Legally, they can't say who has the appointment, when or where the appointment is, or what doctor or type of doctor the appointment is with. And since my family sees at least 10 different doctors, its a useless call, but if you miss it, you have to pay.  

So I tend to call the office to make any appointments or changes, and other than my awesome dentist, every other doctor I work with must seek out the nastiest and most useless receptionists on earth.  Is there an annual competition to see who can be the meanest, rudest and least competent?  What is it about working the front desk at a medical practice that makes people so useless and mean? 

So unrelated Dentist question, what is up with all the specialties?  When I was a kid, you went to the dentist for anything in your mouth, period.  Today, my family has seen dentists, periodontists, extractionists (OK I made up that term but my wife went to someone special to have a tooth pulled) orthodontists, maxiofacial something-or-other, endodontists and some guy working out of a van who I am now thinking was not legit. 

It's not a complaint, far from it.  My daughter had parts of her gums transplanted so she had enough gum to get braces. (sorry for all the medical jargon there) Now she has nice straight teeth, unlike her dentally-retarded old man.  Its amazing what they can do, I mean, I am seeing a sleep-apnea dentist!  The field has really seen some amazing advancements in my lifetime.