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Troubleshooter: What to do about patients who don’t confirm their appointments?

April 11, 2019
This office needs a policy in place for patients who simply never confirm their appointments, then leave the dental team wondering until the last minute whether or not they'll show up.

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QUESTION: What should we do with patients who don't confirm by the night before their appointments? Do we just pray they show up or do we take them off the schedule and try to fill that opening? We need to set protocol for what to do in the future. It's my experience that we just do everything we can to confirm, such as call, leave messages, text, email, etc. If a patient doesn't respond, we leave the appointment as is and pray they show up. What else should we be doing to avoid these last-minute experiences?

ANSWER FROM LAURA HATCH, founder of Front Office Rocks:
Thank you for the question, and that’s a tough one to answer as there are many variables. What type of an appointment is it? Are they typically a reliable patient? Have they paid a deposit in advance? How good has your team been about the importance of confirming with your office in the past? There are many more variables.

I guess I would break this into three categories—patient history, type of appointment, and office policy communication.

Patient history: If you have patients who have not had an issue failing or cancelling last minute in the past then you should probably give them the benefit of the doubt and hope that they show up. However, when they’re in the office in the future, make sure to clearly ask them to confirm one way or the other with your office and explain to them why you’re doing this. If they don't show or cancel, then you need to retrain them that this is not OK and you cannot book them another appointment if they do this again. Make sure you are very clear, and then enter good notes in their chart about the visit so they don't try to do this again.

Type of appointment: If this appointment is a two- to three-hour type of production appointment that will leave the doctor up nights wondering if the patient is going to show, then a few days before I would suggest that you make it very clear in voicemails, emails, and texts that if they don't confirm their appointment then it will be cancelled to make room for another patient. Then no matter what, going forward, it is important to reiterate multiple times with patients that they need to confirm their appointments with you or there is a chance it will be given to another patient. Also, getting a patient to pre-pay for an appointment or put a deposit down will jog their memory to get them to confirm and show up for their appointment.

Office policy communication: It is vital that your office is super clear with patients from the moment they schedule about the need to confirm their appointments. Explain the reason why and then let them know that if they don't confirm at least 24 hours in advance that you might have to cancel their appointment to make room for someone else. I’m not necessarily suggesting that you do that, however, this type of clear language should be used to help "retrain" patients. Their appointments are not optional. If they can't make it to their appointment then they need to give your office ample notice or you might not be able to pre-book them in the future. Always make good notes in patients’ charts so when they try to argue that no one told them, you can quote to them the day and the time that the conversation took place.

My final thought is to stop pre-booking patients who do this to your practice regularly. You know which patients will more than likely not show up for their appointments. Don't give them an appointment in advance that they will more than likely fail. If it’s someone your team likes but they’re just not reliable, then put them on a same-day-only list and call them when you have openings. The most important part of this is to do whatever you can to be in control of your schedule—do not let the schedule control you and your office.

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