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I hope you were not too surprised with your investigation of how your front desk answers the phone and what your actual conversion rate to an appointment looked like. It is startling at the reality of its impact but remember that in a Fixer Upper, we leave no stone unturned. Searching out the true numbers is much like demolition day in a home remodel. You have to tear open the walls and inspect everything. Like this example, you will find other areas that you will want to address as you work on each of these “one things” that are presented each week.
This week I want to touch on cancellations and no shows. Remember that we are improving our conversion rate of calls to appointments by at least 5%. That means that each person who makes an appointment has two things that can happen. They show up or they don’t and having them not show up is a huge production killer as well as a representation of how well our systems and protocols are really working.
Cancellation and no-shows are an unfortunate reality in dentistry. The national average is 15% each day. While you can never eliminate patients not showing up, you can easily lower that percentage by 5%. So, our goal is 10% or less with the caveat that you should also have a goal to fill the appointment slot of every one of these cancellations and no shows. At the end of this post (in the PS) there is a link to secure a report that can show you how to get a complete explanation of scripts, tricks, and protocols to eliminate cancellations and no-shows. For the purpose of this post, we are asking you to track the number of cancellations and no-shows so that you have a starting percentage to work with. For many of you, you will find that if you have poor protocols your percentage could exceed 20%.
While you are gathering information and getting our report, I want to give you the reasons that patients cancel or don’t show up.

  1. Confirming too soon: How to confirm is an entire article unto itself. Suffice it to say that you need to be confirming the morning of the day before the appointment. If by some chance they can’t come, then it gives you all day to fill the appointment for the next day. Keep in mind that leaving a message or telling someone other than the patient about his or her reservation for this appointment is not confirming. You’ll be surprised at what staff consider “confirming”.
  2. Scheduling patients that are past due on their accounts: This can be almost a sure thing. People who owe you money don’t refer and they don’t show up for their appointment. The secret is figuring our how to never have patients owing you anything.
  3. Scheduling patients too far in advance: Any further than 4-10 days out is too far in advance. Things come up or circumstances change. Keeping this rule (within 4-10 days) insures that this will not be likely. If you find yourself scheduled out further than that, then you have a staff capacity problem, facility capacity blockage, or poor systems in scheduling.
  4. Not fully addressing the patient’s concerns: The common ones are time (inconvenient hours), money (not fitting the cost into their budget), and fear. This all comes down to having perceptive staff with great people skills who are sensitive to the patient and consistent on the system of scheduling.
  5. Apathy or lack of trust: When patients don’t like you or are not comfortable with any of the above, they often times will go ahead and schedule while never intending to come in at all. It’s easier and quicker to say “yes” because they really just want to get out of your office ASAP.

These seem pretty straight forward, but necessary to stop the bleeding and move on with the process of completing your fixer upper. This is how you Summit.
Michael Abernathy, DDS
972-523-4660 cell


Just scroll down to “Solving the Cancellation and No-Show Problem”. You will receive directions for downloading a pdf file (30 pages) AND an mp3 audio file (47 minutes). These each provide excellent material for a couple of staff meetings.