Patients’ Funniest Excuses

Classic Patient Excuses for Missing Dentist Appointments

We did a survey asking dentists about the funniest excuses they’ve heard from patients for missing appointments. The clear winner was the toothache defense: “My tooth hurts too bad to get out of bed.”

Other highlights include, “My windshield wipers aren’t working and it might rain,” “I had to go shopping for my daughter’s bat mitzvah dress,” and “I went a movie instead.”

Here were a few more classics from dentists:

  • “A model doing a photo shoot said she was bitten by a lion. A cop was involved in a shoot out.” (New York endodontist)
  • “The patient was in jail!” (Virginia dental office worker)
  • “One patient wanted to know if his insurance would cover the broken appointment fee!” (General dentist)
  • “We always document patients’ excuses when missing an appointment. Sometimes the same grandparent passes away unexpectedly two or three times in the same year!!” (Texas dentist)
  • “‘I have a hangnail.’ Also, ‘My dog has diarrhea.'” (North Carolina dentist)
  • “‘The goats got loose!'” (Maryland pediatric dentist)
  • “‘My dog ate my appointment card.'” (Arizona dentist)

Have more excuses to share? Post them here! Plus, check out the full results

Dentist Appointments: No-Shows Must Pay Anyway

Dentist missed appointment feesMissed dentist appointment fees have recently made headlines, with one Canadian man complaining loudly about a $400 cancellation charge.

Many dentists charge patients missed appointment fees. Typically, these fees tend to be about $25-50 per appointment. But there’s a lot more variation than you might expect!

A recent survey we conducted showed that an average of 1 in 10 patients is a no-show. That’s a 10% reduction in dental practice profitability, and a serious dental management issue.

The $400 missed appointment fee

Roland Ikporo’s son got a toothache last month, but their family dentist was closed. So he took his son instead to Calgary’s Expressions Dental clinic.

The dentist there conducted an exam and took x-rays at a cost of $150. He told Ikporo that his son needed 4 teeth removed right away. So Ikporo made another appointment for two days later.

But within an hour, Ikporo cancelled the appointment, realizing that his general dentist would be cheaper. (While Expressions Dental would charge $1,700 to remove the four teeth, the dental work was only $800 from their regular dentist.)

Though called the dentist office to cancel the appointment less than an hour after he made it, his Visa was billed an additional $400 missed dentist appointment fee.

Ikporo had in fact signed a consent form that explained the clinic’s cancellation policy: give 72 hours notice or be charged $200 per hour of missed appointment time. So by booking an appointment less than 3 days in the future, Ikporo had no ability to cancel.

Angry, Ikporo has registered a complaint with the Alberta Dental Association and College. They are now investigating.

Just an observation: Even if he pays the $400 fee, Ikporo will still have saved money by having his family dentist perform the extractions… The general dentist‘s $800 fee plus the $400 cancellation charge is still significantly less than the $1,700 quoted by the dental clinic.

What’s your policy?

Many dentists find that a $20 cancellation charge just doesn’t get the job done. How does your practice handle no-shows?

Read more: Father angry over $400 dentist cancellation charge

Missed Appointment Excuses (video)

Dentists hear a lot of excuses from patients with missed dental appointments. In this survey, we asked about the funniest ones.

The toothache defense won, hands down. “My tooth hurts too bad to get out of bed,” complained one patient.

  • “A model doing a photo shoot said she was bitten by a lion,” recounted an endodontist.
  • “One patient wanted to know if his dental insurance would cover the broken appointment fee!” said a general dentist.
  • “One patient told me, ‘My windshield wipers aren’t working and it MIGHT rain,’ when there was a 0% chance of rain in the forecast,” shared an orthodontist.
  • “I went to a movie instead,” one patient told his periodontist.
  • “The goats got loose!” explained another to the pediatric dentist.

Read more: Funniest Excuses from Patients for Missing Dental Appointments

Dental Patients Skip Hygiene Appointments the Most

Dental Patients Skip Hygiene Appointments the Most GraphDentists report that hygienist appointments are missed an average of 13% of the time, a survey by The Wealthy Dentist reveals, indicating that dental patients don’t seem to value dental hygiene appointments as much as they should.

Whereas regular appointments with the dentist are only missed 9% of the time, an indication that dental patients tend to respect their appointments more when a dentist is involved.

Rural dental patients showed the most respect for hygienists with dentists reporting only 3% of appointments missed, compared with suburban dentists who reported the highest percentages of hygiene patient no-shows.

Percentage of missed dental appointments graph

The Wealthy Dentist survey revealed that all dental patients prefer to see their dentist with suburban, urban, and rural dentists all reporting low percentages of dental patient no-shows when dental appointments included a consultation with a dentist.

Here’s what dentists had to say about how they handle missed appointments —

“We usually do not charge them for the first offense, but call them to reschedule, and tell them if they miss again, we will have to charge them then.” (Illinois dentist)

“We don’t schedule patients after 2 missed appointments.” (Texas dentist)

“After 3 broken appointments, we put the patient on our VIP list where they can only get an appointment the day that they call if we have one available.” (Alabama dentist)

“We call them immediately to find out why they have missed the appointment. We educate them as to why it is crucial to keep their appointments. Not to mention that we have other patients waiting to be seen in that time slot if they had called and given enough notice. We’ll fire the patient after 3 ‘strikes’ if there is a pattern.” (General dentist)

“It’s a big challenge. I wish I had a great answer. We have a written policy in our newsletter to call at 10 minutes into the appt. We then send a letter. The first one is a warning — free — then a charge.  We hear all the excuses imaginable, people less respectful than 30 years ago…” (Urban dentist)

“When they miss one appointment we immediately give them a friendly reminder about our broken appointment policy. We use Smile Reminders (text, e-mail, and phone) to remind our patients about their appointments 2 weeks, a few days, and the day before their appointment. This has greatly reduced our no shows to about 5% and also gives us time to fill their appointment if they have to move it. We are extremely happy with our low percentage of no-shows!” (Ohio prosthodontist)

“We made them prepay for future appointments and/or put them in a phantom column where they really have no time reserved. If they show up, we hope someone else doesn’t show up so we have time to work on them.” (Louisiana dentist)

“Try to reschedule them when they call. If not, have a list of unscheduled appointments to work from to fill empty appointment times.” (Connecticut dentist)

“We charge $50.00.” (California dentist)

Dentists, what has been you experience with missed dental appointments and how do you handle it?

Some Dentists Fire Patients After Missed Appointments

Some Dentists Fire Patients After Appointment No-Shows36% of dentists don’t charge for missed dental appointments — no matter how many times a patient is a “no-show.”

Only 5% charge a fee for the first offense, while 39% charge a fee after the second missed appointment. 20% of dentists charge after the 3rd missed appointment.

With the current economic conditions, The Wealthy Dentist decided to ask dentists if they have been charging for missed appointments.

Boston’s Pilgrim Hospital is in the news this week for reveling that in the first 10 months of 2011 patients failed to attend almost 17,000 appointments. Thats about 49 missed medical appointments for every day of the year.

“Time is money!” complained one dentist, and he is right. A missed appointment is an appointment that can be filled by other patients. Missed appointment fees ranged from $25.00 to $150.00. The average fee is $55.00.

In this survey, 42% of dentists said they rarely or never fire patients, 34% will fire a patient after the third missed appointment, and another 24% sometimes fire patients, but they have more than three chances.

The following dentists’ comments were selected to share how dentists are handling missed appointments —

Pre-paying is popular …

“We ask the patient to pre-pay for future appointments.” (Illinois dentist)

“Repeat offenders are put on ‘probation’ where they must pre-pay (the full price, non-refundable) before we will schedule them again. This way we don’t ‘fire’ them, they either pre-pay or leave the practice. They are usually on ‘probation’ until they consistently show up.” (Kentucky dentist)

“We have them pay before the appointment and if they break the appointment, the fee is deducted from their account.” (Missouri dentist)

After three missed appts we will not reschedule unless they prepay in full for whatever the appointment is for. It works great. We have a great practice and people know the value that they receive here.” (Colorado dentist)

“We ask the patients who no show for 2 appts or more to prepay for further visits.” (General dentist)

“We just charge them little more when they come next. Also if they are entitled for any offers or discounts don’t give them that.” (General dentist)

Confirming helps …

“Confirm. Confirm. Confirm.” (General dentist)

“Have your patients give you the cell number where they receive texts and text them their appointment. Works like a charm.” (California dentist)

“We confirm by phone, email and text message.” (General dentist)

“We double book or call patient the morning of appointment.” (California dentist)

“We send a sms reminder the day before the scheduled appointment.” (General dentist)

Same day or on-call appointments only …

“After the second time we choose the option of putting the patient on our short call list only.” (Georgia dentist)

“We don’t give 3rd time offenders the opportunity to schedule in advance. We put them in our ‘Short Notice Club’ and call them when we have an opening or they can call to see if they can get in that day.” (Oklahoma dentist)

“After 3 missed, the patient must call on a day they would like to come in and see if there is an appointment available.” (Pennsylvania dentist)

“We don’t “fire” them but put them on a VIP list where we call them when we have a same day appointment available.” (New Hampshire dentist)

Fire them …

“My letter to the patient who I am dismissing is actually very nice. It states that our priorities do not match and that they would be better served by another dentist and to please let us know where to forward their records. A lot of times, the patient begs us to let them come back to the practice and they become our best patients ever about being there for their appointments even in bad weather, etc.!” (Alabama dentist)

“We send three letters and then dismiss patient with a 30 day emergency window so they have ample time to find a new dentist that will be more conducive to their schedule.” (Missouri dentist)

You must get rid of them because you can not afford them. The other thought is to give them a stand-by appt. They may have to wait a while to be seen.” (North Carolina dentist)

“After a new patient reschedules/misses an appointment twice, we fire/do not reschedule. When existing patients break numerous appointments we notify them to call us on a day when they have extra /free time on their schedule and we will see if we can work them in at that time (this way we are not blocking an actual appointment for them). The best approach would be to require a credit card at time of scheduling to hold the appointment.” (General dentist)

How do you handle missed appointments? Have you ever “fired” a patient?


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