With the fixed costs of running a dental practice rising all the time, it’s important practices maximise their opportunities to see patients. One way to ensure this happens is to reduce the number of missed or cancelled appointments. Practice manager and Chair of ADAM (Association of Dental Administrators and Managers), Lisa Bainham, shares her advice on how to keep ‘no shows’ to a minimum.
Take the initiative
I prefer to be in control, so I prefer my teams make courtesy calls. I brand them as ‘courtesy calls’ as people find that more acceptable than one which starts with, “I’m ringing to remind you you’ve got an appointment.”
So courtesy calls could be along the lines of, “We know how busy everybody is, which is why we’re just giving you a courtesy call to check you’re still okay to come to your appointment.” Also, I would frame it as a statement that assumes they will still be attending, rather than presenting them with an opportunity to say it’s no longer convenient.
Cancellations or missed appointments are probably running at a rate of between 5% and 8% in most practices at the moment, and there’s a cost to having those appointments unfilled. In an average practice, I would say you’re looking at about £150-an-hour, in costs to run the practice. That figure doesn’t include wages which, again in an average practice, could be anything between £200 to £300-an-hour for salaries for the practice. So, for example in my practice, our hourly running costs are around £148 based on probably seven chairs being full all the time.
So, if an hour’s time is wasted, the costs are still there and need to be covered. Nurses still need to be paid, as will the electric, the rent, and everything else. And patients don’t always realise this.
It’s not personal, it’s just business
It’s important to keep the 5% to 8% of missed and cancelled appointments to a minimum. You can do that by implementing some systems to help achieve that. This could mean making sure that right from the start you have a patient agreement. So, with any new patient you set out, ‘this is what we’ll do for you. And this is what we expect of you.’
However, as part of that agreement if you decide you will charge for missed appointments, you have to let patients know that’s the case right from the start. And as long as you have that agreement, then you stand by it. In my experience, not all practices stick to this, though.
I think they feel uncomfortable using a missed appointment fine. However, it’s all about how you word it. I try to position it as, ‘this is how we have a respectful, good relationship.’ You set things on the table and then they’ll either not miss an appointment or, if they do and they get a charge, then they appreciate those were the terms they agreed to.
However, there’s no need to be unreasonable. Sometimes we have to flex a little bit. So, having this system of mutual respect right from the start, giving patients the message that missed appointments are not great, this is what we need. We want to make sure that we are reasonable and keep our costs down to a minimum for you. However, if we have missed appointments, then we do have to review them.
We found that prepayments also help keep the missed appointments down. And the way that I’ve justified that is to explain to patients that it has a statistical reduction in our missed appointments and wasted appointments. That helps keep our prices down. And that includes plan fees and fee items. If you have a large percentage of missed appointments, your prices are going to have to go up to reflect that, if you are to survive.
But, at the end of the day, if you’ve got patients that aren’t turning up and are costing you money, they aren’t the patients that you really want in the practice. I have and will terminate relationships if they are bad attenders.
Lisa is involved in all aspects of the practice, including, compliance, accounting and business development. Lisa was awarded Practice Manager of the Year and was very proud to also win Practice Manager of the year 2016 at the Dental Awards, Best practice UK & Best Patient Care UK, and is now a Judge. Lisa’s knowledge and experience over her last 24 years enables her to support other practice managers in her role as President of The Association of Administrators and Managers, who have members throughout the UK and speaking at a wide range of Dental Events and covers a wide range of topics including, Leadership, Team Building, Complaint handling, Customer Service, patient journey training, and her PM mentorship programme. Lisa also provides support to practices across the UK & Ireland through her consultancy, Practice Management Matters.
Lisa still works in practice, making her relatable and empathetic to the challenges many practices face.