Ten Percent of Appointments Are No-Shows

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Dentist appoint ment no-shows Breaking news: sometimes patients miss their appointments!! In this survey, the average was about 10% for doctor appointments and 12% for hygiene appointments, which is a lot of empty chair time.

"It is the biggest headache of my career," said one dentist. "I've tried confirming twice... tried sending cards with cute pictures... tried recall cards with their handwriting scheduling the appointment... tried counseling patients... tried charging... I still have many multiple no shows EVERY DAY."

We asked, "What do you do with patients who miss appointments?"

Charge repeat offenders

"Bill them the second time." (New Jersey dentist)
"Call and reschedule. Charge if more than 3 times."
"Fee optional at staff discretion." (Florida pediatric dentist)

Charge patients for missing appointments

"$50 charge; sent statement showing charge & our write-off for 1st time. $50 charge for each succeeding 'No Show' apt." (Connecticut dentist)
"Charge them." (Ohio pediatric dentist)
"Charge a broken appt fee (PPO) or charge them more at their next appointment." (Florida dentist)
"Patients of record are charged a $40 cancellation fee if they were confirmed in person the day before." (Virginia dentist)

Three strikes, you're out

"First time they break an appointment, they get a notification of broken appt policy and fee. Second time, we charge $50/hour. Third time, exit patient from practice unless there is a good excuse." (Georgia periodontist)
"1x nothing 2x fee 3x out" (General dentist)
"Call within ten minutes and send series of BAP letters. If they miss more than 3 appointments in six months, we send a dismissal letter." (Pennsylvania dentist)
"Cuss to silently to myself about their disrespect of our time and other patients - then try to reschedule. If this occurs 3 times we don't appoint again but will see them on a 'come in and wait' basis." (Kansas dentist)

Out after two strikes

"Send letter the first time, dismiss after second time." (Maryland pediatric dentist)

Require pre-payment

"We have them pre-pay for the next appointment." (California dentist)
"Two consecutive no-shows (or 3 no-shows in 2 years) requires prepayment of the next appt." (Kentucky dentist)
"Call, letter, then deposit." (South Carolina periodontist)
"We give people a chance, but people are either reliable or not. If it is chronic, we require a prepayment or credit card." (Tennessee dentist)
"We make them prepay after 3 broken appts. We don't include late cancelations, even though we should." (North Carolina dentist)

Charge a "reservation fee"

"Ask them for a reservation fee." (Michigan dentist)

Just make *everyone* prepay

"I don't waste a lot of energy on changing bad behavior. We let them slip out the door to other offices. All Doctor appts are prepaid so cancellations are honest problems." (Texas dentist)

Send them letters

"First we send a letter explaining the consequences of missed treatment and how they're hurting themselves and another patient by keeping us from having that appointment for the patient that was waiting for a sooner appointment. The letter also states Next time YOU PAY. The second letter...PAY UP!" (New York dentist)

Acknowledge it happened

"Attempt to get in touch with them by phone or mail or e-mail." (Utah dentist)
"Call or letter." (Illinois dentist)
"Ring them." (General dentist)
"Send letter" (New Jersey dentist)
"Reschedule" (Illinois dentist)

A major problem for some

"Big problem for 20 years. I've tried confirming twice... tried sending cards with cute pictures... tried recall cards with their handwriting scheduling the appointment... tried counseling patients... tried charging... Now after 2 missed appointments, I put them in an extra column on my scheduler and see them anytime that there is space available (no set appointment time). I still have many multiple no shows EVERYDAY. It is the biggest headache of my career." (South Carolina dentist)

They're the kind of patients you don't mind losing

"Try to replace them with better patients. That's not too difficult because the appointment-missers usually don't remember to call back for another appointment. If it's a long-time, reliable patient, we recognize that anyone might forget something just once, so we call them back and re-appoint." (California dentist)
"New Patients First Time, we give them another chance, but then they are out of the practice. Existing patients if they don't show at all and don't call, we charge them $50. If they call with little notice, we give state our policy and give the one more time. They are out of the practice if they don't pay the fee." (Texas)

Avoid charging fees

"Call and say we are concerned and hope there is nothing wrong. Then determine our plan based on the answer and patient history with the practice. If misses are ongoing, patient is dismissed from practice. No missed appointment fees are ever charged, creates bad will." (Colorado pediatric dentist)

Make them sign a contract

"Every new patient reads and signs the broken appointment policy at our office before their first appointment. Patients are reminded about their appointments several days in advance and the day before using the contact method the patient prefers. Those that break appointments without 24 hours notice are charged the broken appointment fee. We have very few broken appointments (approx. 5 to 8%)." (Ohio prosthodontist)

Make them feel guilty

"Warn them that we cannot allow it to happen again, tell them we have patients who would have loved that time spot, that I had to turn away. Tell them if they had just let me know with a little notice I could have filled that spot." (California dentist)

React with peace

"Say a prayer for them."

React with violence

"We charge them $500 and send a hit man to their house and beat the sh*t out of them!" (California dentist)
"Kill them. P.S. Suggested topic for future survey: how to dispose of dead bodies." (Connecticut dentist)

Note: Survey sample included 47 respondents.