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913: Metric Mondays: Pre-Appointment Percentage – Miranda Beeson

Do you start every month with an empty schedule? Is your team scrambling to fill your chairs? There's a better way to keep your practice full! In this episode of Metric Mondays, Kirk Behrendt brings back Miranda Beeson, ACT’s director of education, to break down pre-appointment percentage and the missed opportunities when you don't schedule your patients’ next visits. To learn how to pre-appoint patients and keep them tethered to your practice, listen to Episode 913 of The Best Practices Show!

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Episode Resources:

Main Takeaways:

  • Keep your pre-appointment percentage above 65% to reduce patient attrition.
  • Set the expectation that every patient leaves with their next visit scheduled.
  • Scheduling your patients’ next appointment is the default. It’s not optional!
  • When patients cancel, reschedule the appointment in that moment.
  • Tie patients’ appointments to their health goals to build value.
  • Have a system to work your unscheduled patient list.

Quotes:

“If you have people pre-scheduled for restorative appointments, hygiene appointments, any future appointments, that high re-appointment percentage is going to mean that you're not starting each month with an empty schedule or a lot of holes in your schedule, relying heavily on last-minute quick-fill situations just plugging those holes, or high dollars going into marketing to fill your chairs. It reduces that risk of patient attrition.” (2:20—2:47) -Miranda

“I mentioned loyalty. When you have people tethered to the practice with a future appointment, it’s going to keep that attrition lower. Those people — what we call the “leaky bucket” — falling out the leaky bucket, it's been more than 18 months since they've been in, they're no longer active, it's that much harder to get them back into the practice. So, it helps to limit patient attrition. Patients with nothing scheduled are far more likely to fall through the cracks and eventually leave your practice. A lot of times, by the time they need a dentist, either one, you don't have availability, or two, they've gone and found somebody else. They complained to their friend about something, and they've gone and found another dentist. So, when you keep them tethered to your practice, it keeps that loyalty. It keeps that patient retention and it helps with schedule stability, forecasting, and knowing where you're going in terms of financial health as well.” (2:47—3:36) -Miranda

“We can't highlight enough that people are not thinking about us as often as we are thinking about patients. We're always concerned in the dental practice of, ‘Who is in our schedule? Do we have enough patients? Do we have enough production? Whatever happened to Mr. So-and-so?’ Well, Mr. So-and-so probably hasn't thought about us at all because everything is feeling good. Everything is going fine. By the time you do catch up, they're like, ‘No way, it's been two years.’ So, it really is our responsibility to help get them pre-appointed so that they're tethered to the practice. It reduces the amount of dollars we’re going to spend on recall attempts and our team having to call and reach out, call and reach out.” (5:04—5:40) -Miranda

“We know this is going well when we are having pre-appointment percentages above 65%. The benchmark in the industry is 65% or more of your active patients. You really want to be pre-appointed for future visits. When that's going well, when you're at that 65% or more, typically what that looks like is your team is consistently scheduling the next visit before the patient leaves. It's the default. It is not an option. It's not a consideration. It happens every single time, unless the patient is moving or they're a snowbird or something like that — which, I would actually argue you could still schedule them for next summer or next winter. But the team is consistently scheduling. That means your assistants are scheduling the delivery before the patient leaves from their crown prep. If it's the crown delivery, they're scheduling the next restorative procedure. Your hygiene team is pre-scheduling the future hygiene visits.” (5:41—6:41) -Miranda

“Your hygienists and your administrative team [should be] confident using patient-focused language that builds value in the next visit. We want to make sure that when we’re pre-appointing we’re using language that's confirming language. That's not, ‘We’re going to pencil you in. Let's see how this goes. Why don't you give us a call? I get it. Your schedule is busy. Call us back when you have some time, and we’ll find a spot for you.’ We really want to make sure the team is aligned on having that high-value, confident, patient-focused language. When your number is 65% or more, that’s likely happening more often than not in your practice, and the unscheduled patient list is probably being worked actively.” (6:42—7:22) -Miranda

“When it’s not going well, when [your pre-appointment percentage is] under 65%, typically, that means patients are leaving without scheduling. A lot of times, we’re being told, ‘Just give us a call when you’re ready,’ or they say, ‘Oh, I don’t have my calendar with me.’ The other thing that can happen is when a patient cancels, your team may not be rescheduling them in that moment. They were scheduled, and now they're not. So, little things to adjust how we respond to cancellations can help impact this metric. A lot of times, it just comes down to the team lacking clear expectations or accountability for it being the default that we need to schedule. If we don't express that as part of our patient workflow, that the end of that workflow is resulting in them scheduling their next visit and that that's a piece of accountability and expectation, then we can't really hold them to that either. So, if nobody is reviewing those follow-up systems or looking ahead to make sure there is accountability to the default of pre-scheduling, you're going to end up in a position where that number is not going well, and you have holes in your schedule, and you have people falling out the bottom of the bucket, and patient attrition. Then, you have to spend a lot of money to get new patients because you've lost the patients that you used to serve. So, it’s really a downward spiral if you can't stay ahead on the pre-appointed percentage.” (7:51—9:16) -Miranda

“It’s just a matter of fact. We’re wrapping everything up and it’s, ‘Well, let's go ahead and take a look at the schedule so we can secure your next visit with us.’ So, we’re always wrapping it with that affirmative statement. It’s not an option. It’s not like, ‘So, do you want to schedule, or are you thinking? Do you want to call us back?’ No — we have to be confident that the next step here is for us to go ahead and take a look in the future and reserve some time.” (10:04—10:30) -Miranda

“I love the phrase “reserve time”, and I like saying who the provider is. So, if I'm the hygienist, I might say, ‘Let's look ahead in the schedule and reserve time for your next visit with me.’ Now, you've made that connection and accountability to the patient to you. Now, if it's not me, the hygienist scheduling, if I'm an administrative team member — perhaps I'm scheduling for the doctor or for the hygienist — I'm going to say, ‘Let's go ahead and take a look at the schedule and reserve your time with Dr. Awesome or reserve that time with Michelle,’ because we want to make sure that they hear it as a reservation and it's connected to a provider, to a person, because people are much less likely to want to disappoint a person that they feel respect for or a kinship with. So, when you can use that language, it really builds value about that next visit, and they're more likely to keep it.” (10:31—11:23) -Miranda

“Sometimes, teams will say, ‘Well, our hygiene schedule is so busy. I'm scheduling ten months out.’ Yes, you are. However, if we don't pre-schedule them now, by the time they do call back or we chase them down, it could be 18 months or two years before they get in. So, it's also better for the patient, even if you're busy, to go ahead and find that pre-appointed slot for them and reserve that time.” (12:16—12:40) -Miranda

“The other thing is using outcome-based language when scheduling, tying the appointment to the patient's health. If they've shared their goal with you, tying it to the goal, not just, ‘You're going to be due in six months,’ or ‘You're going to be due by this date.’ A lot of times, we get hung up as clinicians, especially on that due date, based on the turn of the calendar and the 1960s toothpaste commercial about “twice a day, twice a year”. But what we really want to do is customize the conversation so that the patient knows how important this next appointment is to whatever their health goal is. So, ‘Mr. Jones, you shared with me that it’s really important to you to keep your teeth. I know that was a rough experience for your parents. We’re going to do everything we can to help take care of that for you. To help you do that, we’re going to go ahead and take a look at the schedule and see if we can reserve some time in three months with Michelle, our hygienist, so that we can keep you on track.’ Again, you're elevating the language. You're building the value around the appointment, not only so that they'll schedule now, but also so that hopefully they'll maintain that appointment.” (12:52—14:01) -Miranda

“You really want to implement a reliable follow-up system — unscheduled patient report, hygiene follow-up system, anything that's going to be measuring and tracking the people that do not currently have a future appointment — and that's worked weekly or biweekly by someone who really owns that system. So, typically, an administrative team member will be responsible for having the list of unscheduled patients or hygiene patients without a future appointment. They're consistently calling that on a regular rhythm. I say calling that, but they're probably building it in text, and they're probably building it in email. But you also should be making those personal connections, and they're working that. A lot of times, what we see is that people only call those lists when they're trying to fill a hole, when someone has cancelled and they need to fill something short notice. But it should be something you're calling as part of your regular weekly checklist rhythm so that you're always having touch points, because it can take 10, 15 attempts to reach out to someone before you actually get a hold of them and have them in your schedule again.” (14:13—15:15) -Miranda

Snippets:

0:00 Introduction.

0:37 Pre-appointment percentage, explained.

4:53 How this metric impacts your practice.

9:48 Favorite phrases for scheduling patients.

11:52 Countermeasures.

15:16 ACT’s BPA.

Miranda Beeson, MS, BSDH Bio:

Miranda Beeson has over 25 years of clinical dental hygiene, front office, practice administration, and speaking experience. She is enthusiastic about communication and loves helping others find the power that words can bring to their patient interactions and practice dynamics. As a Lead Practice Coach, she is driven to create opportunities to find value in experiences and cultivate new approaches.

Miranda graduated from Old Dominion University, and enjoys spending time with her husband, Chuck, and her children, Trent, Mallory, and Cassidy. Family time is the best time, and is often spent on a golf course, a volleyball court, or spending the day boating at the beach. 
ACT Dental Team

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