Recall ... the heartbeat of the dental practice

Nov. 1, 2010

By Denise Ciardello and Janice Janssen

One of the many concerns in a dental practice today is having an effective recall system. Every office has a different recall system, and all practice management software handles recall a bit differently. Any recall system is only as good as the person responsible for it. That person must monitor it consistently for the system to be effective.

Over the past few years, many offices have started to avoid the term “recall.” It is perceived by some to have a negative connotation, and some feel that the term decreases the importance of the professional dental visit. If the patient thinks it is just a cleaning, the visit will lose its value as a preventive measure to reduce tooth decay and periodontal disease.

With that in mind, many hygienists have started to use alternative terms such as continuing care, preventive care, recare, or professional cleaning. The words you use register with your patients, and by using terms of value, patients will be more likely to schedule an appointment and not as apt to cancel. In addition, words more accurately describe what procedures are performed by the hygienist, and straightforward verbal skills help make a continuing care system successful. For this article, we will refer to scheduling a patient for a routine hygiene appointment as recall.

The most important thing is for your practice management software to include a recall system that your staff can understand. If the software is too complicated, get a new software system or offer training for your staff.

One common recall system allows the staff to automatically create a new appointment at the time of patient checkout. The software will place the next appointment six months out or at whatever time interval a patient’s care is set. This recall appointment’s time and date can be modified to accommodate the patient’s schedule.

Another system that is still in use in dental practices is the “tickler” file. This is generally a bunch of index cards that require a willing staff member to keep up with them every month. Offices that use this system usually give the same reasons:
1. Having patients address their own reminder cards is a great way to get their attention.
2. The computer may crash and lose all of our information.
3. The computer has wrong information in it.
4. We do not understand how to use the recall system in our computer.

This system is antiquated and time consuming. It is NOT efficient, but at least the office has a system in place. If you have a computer system, it would be beneficial to look into using it for recall. Whether you manage your recall through the “tickler” system or on the computer, a very specific protocol needs to be maintained.

Preappointing the hygiene appointment

An active preappointing system is far more productive and creates a superior recall system that will improve the efficiency of any dental office. Practices that are committed to preappointing correctly will swear by its benefits. Good organization and outstanding verbal skills will help patients respond favorably. If patients often decline, it is usually because the hygienist asks, "Would you like to schedule your next visit?" This is a closed ended question, which requires only a yes or no. Most often, the response to this kind of question is, "No. I don’t know my schedule that far in advance. Send me a postcard and I’ll call you."

To maintain control of the conversation and receive a positive response, the hygienist should tell the patient what is going to be done. "Your next professional cleaning appointment will be in May. I can see you on Tuesday the first or Wednesday the second. Which of these would be the most convenient for you?" Create an image that conveys you are doing the patient a favor. This requires advanced verbal skills, a pleasant personality, and a genuine desire to make everyone happy.

Postcards should be mailed out three to four weeks ahead of appointments. This reminder gives patients time to reschedule if necessary, and gives the appointment coordinator time to repair any openings in the schedule.

When dismissing the patient after treatment, whether with the hygienist or dentist, create a perception of value and importance in the mind of the patient by saying something like, "Take care, Mrs. Smith. I’ll see you at your continuing care appointment in May." Every patient should be released with the reminder that there is another appointment, even if it is six months away.

So what happens to those patients that do not preappoint? In six months, someone gets the daunting task of running the report and calling these patients. This is a much-hated job because there is little reward for so much work. Before the call can be made, research has to be completed — when was the last hygiene appointment, what does the insurance allow, what X-rays are needed, how long should the appointment last, and is there a balance due? Then all phone numbers must be called and messages left at each number.

Typically only one in 20 calls are “hits.” An effective recall system needs to personally get in touch with patients at the right time of day. Statistics prove that it is easier to get hold of patients between 5 p.m. and 8 pm. Do you see why it is so much more efficient to preappoint?

Recall, or continuing care, is one of the most important systems that you can organize in your practice. The key to a successful continuing care program is to make sure that it is a routine task, just as putting in payments or making a deposit. It is too easy for patients to fall through the cracks. Most patients do not keep up with their continuing care due dates. Most treatment is scheduled following a recall appointment. This is why it is crucial to make sure that your recall system is rock solid.

Denise Ciardello and Janice Janssen are respected professionals in the dental consulting industry and cofounders of Global Team Solutions, a practice management consulting firm specializing in team building and team training. They can be reached at [email protected], (314) 644-8424, or [email protected], (210) 862-9445.