Dealing With “No Show” Repeat Offenders

Episode 085

Some frustration behind the mic this week as I discuss having a repeat “no show” offender that found her way back on my schedule on episode 85 of Business of Dentistry.

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This is about a patient interaction I had, I want to know how you would respond. I have a policy we created a year or two ago so my team would know what to do in the event of a no-show or last-minute cancellations. It’s simple: 3 strikes and you are out. If you can’t be here, you cancel, or you don’t show up 3 times then you can’t get back on the schedule. I don’t think it’s harsh, even though some may think so.

We do have exceptions, if someone understands the impact of not showing up and want another chance we’ll allow them to prepay for their visit and reserve time on my schedule. Many people have done this and we haven’t had too many issues.

But this past week we hit a little bump. We had a patient on my schedule again after this person had cancelled or not shown up for 7 appointments over the last year or so.

You can imagine I almost went bonkers when I saw this person was on my schedule. I couldn’t understand why because I had specifically put an alert into our practice management software for this person’s name. The alert said this person was to receive no more appointments! And it had my name attached to the alert so my team would know the directive came from me.

My team overrode that alert and put her on the schedule anyway. When I asked around why this happened no one could give me a good reason. As I put this episode to air I still don’t know why this patient was on my schedule, even though I explicitly said not to allow her in again.

So this patient came in and I talked with her. I asked her several times if she is ready for this treatment and ready to follow through this time. She said yes.

I asked her to be sure because she has cancelled at the last minute or not shown up for 7 previous appointments. She again said yes she was ready to go ahead. I said okay, and told her my team would be in shortly to talk with her about insurance coverage and the like.

I then told my team we needed a 50% nonrefundable deposit for this patient’s procedure before setting an appointment date. I thought that would ensure this patient had some skin in the game. But at the end of the meeting when all was said and done, this patient didn’t set up an appointment.

I’m bringing this up because these are the types of things that kill me on the business side. I understand taking care of patients is important, but sometimes people don’t respect our time or the value we bring.

So don’t be like me and see someone who has cancelled 7 times previously.

My other issue with this experience is that my team basically ignored me and couldn’t give me a reason why they allowed this person to be on the schedule again.

By our office rules this person should not have been on the schedule. And I understand it can be difficult, sometimes people on the phone are pushy, or they give sob stories or all kinds of other reasons about why they need to be on the schedule.

But we can’t allow this, unless we have a very good reason. As the owner of your business you should be allowed to make an exception to a rule or policy or guideline in your practice. Be sure to write it down with input from your team. Don’t make changes based on emotions but on objective data, otherwise it will confuse your team, your patients and potential referrals.

So visit or revisit your policy on no-shows, cancellations, missed appointments. Do cancellations need to be done more than 24 hours before the appointment? Three days before? A week before? How do you define an acceptable cancellation timeframe? Whatever your window for cancellations, you also need to look at how effective you are at refilling that slot in your schedule and adjust accordingly.

These are important areas to look at in your practice and they are also important for your mental health!

To wrap up today’s show I share the three responses to have in a situation like this and the most important thing to learn from these types of experiences. Join me to hear those takeaways on episode 85 of Business of Dentistry.

Tweetable: “Perfection is a journey, not a destination.”

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