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970: Metric Mondays: New Patient Cancellation/No-Show Percentage – Miranda Beeson

Do you have a plan, or do you just hope new patients show up for appointments? In this episode, Kirk Behrendt brings back Miranda Beeson, ACT’s director of education, to break down new patient cancellation and no-show percentage and what you can do to reduce those numbers. To learn how to create strong scheduling, confirmation, and communication systems so your patients commit to showing up, listen to Episode 970 of The Best Practices Show!

 

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Main Takeaways:

  • Track your new patient cancellation separate from your cancellation percentage.
  • If your cancellation or no-show is high, you are wasting valuable chair time.
  • Strengthen your commitment language to communicate value to patients.
  • Send personalized reminders to create an added level of commitment.
  • Have a documented plan for unconfirmed new patient appointments.
  • It is okay to release appointments. Create a clear process for it.

Quotes:

“[New patient cancellations and no-shows are] very common in a lot of practices. We make all of this effort getting new patients to call and to schedule, then we get super disappointed when they don't show up. So, it's really great to actually have data to help support or negate our feelings around, ‘I feel like a lot of our new patients aren't showing up.’ So, this metric actually measures the percentage of new patient appointments that are either canceled or missed without notice. Very similar to how we track traditional cancellations, we're looking specifically at new patients and what happens with those appointments. This data point is going to highlight the strength of your scheduling process, the confirmation or reminder process that you have in your office, how we are communicating with our patients, and measuring how well the team sets and maintains expectations with our new patients.” (1:04—2:08) -Miranda

“When we have a high cancellation or no-show rate, we are making a huge impact in a negative way on productivity. We're eroding productivity from the practice. We are wasting valuable chair time and we're blocking practice growth. So, in many practices, new patients join the doctor first. That's a very common way that a new patient enters the practice. In many practices, that's 90 minutes, sometimes two hours of time, that is blocked for a new patient, especially if you're a comprehensive practice. So, if these new patients are not showing up or canceling last-minute in a way in which we're not able to recover that time, this is open time that can be a huge financial risk to the practice. When new patients don't show up, the practice loses not just that appointment and that productivity but that potential for the long-term relationship with that new patient. And not only that relationship and referrals they might bring in the future, but also future production that that might bring. And depending on the type of practice that you have, that could be a significant amount of future production.” (2:25—3:33) -Miranda

“If [your new patient] cancellation rate is low, then that's telling us we have a pretty good new patient call strategy. We're probably having strong patient engagement, we're building trust on the phone, we're setting very clear expectations about the first visit, what to expect, and what we expect of you, and that the team is creating commitment and value in those appointments as they're building them into the schedule. And when we build value on the call, we use commitment language. We're going to reduce the risk of future cancellations. Then, the other piece around this is, do you have a system for what you do when a new patient isn't confirmed and it's the day before? They haven't sent in their paperwork. Do you have a way in which the team is managing that? If you do, you're probably going to have a pretty low new patient cancellation rate.” (3:43—4:38) -Miranda

“You're spending money and time investing in recruiting new patients into the practice. Then, on top of that, we're costing the practice money and time by having that open chair time. If new patients are being seen in the doctor's schedule and your average production per hour is $500 or $700, and that's a 90-minute or two-hour appointment, that's a whole crown's worth of production that we're losing in the time we could have had that new patient in the schedule. In hygiene, if your production per hour is $150 or $200 and you've just lost those two hours, that's $400 of hygiene production for that day that we can't recover. So, you've already lost it, in a way, by the investment that you're not going to get a return on and the marketing that you're doing. Then, you're losing it again by way of your production. So, it is an incredibly important metric to look at.” (5:54—6:45) -Miranda

“Number one, pre-frame the commitment language. Work with your administrative team on how are we managing these new patient phone calls in a way that we're communicating the value of the appointment and the expectations of respect for that time when we're scheduling. So, you can use language like using the word “reserve” versus “booking you”. You can use the doctor's name or the provider's name that you're reserving that time with. So, ‘We're reserving this time just for you, Sally. We're looking forward to meeting you. Dr. Awesome is going to give you their full, undivided attention for the 90-minute visit when you come see us on Monday at 2:00 p.m. We can't wait to meet you.’ That's very different than, ‘Great. We got you jotted down here in the books. We'll see you on Monday. Looking forward to it.’ There's this different level of commitment language that we're using with those appointments, and we're making sure that they know that that provider is — like, you're reserving this time, but they're also reserving this time for you. So, it's a very specific way in which we're sharing that commitment.” (7:07—8:16) -Miranda

“We want to use multiple channels to remind new patients of their appointments. Text is great. That's probably the most responsive way that people respond now to appointment communication email. Personal calls, but in any way in which you're channeling those reminders, focus on the connection, not the automation. So, every software that you use now to communicate with patients, you can automate. But you can usually customize those automations as well so that they are very personal and they sound personal. And honestly, especially in a concierge-style practice, if you're not seeing 80 new patients a week and you're seeing 10, I'd be using personal phone calls. I'd be reaching out. I know some of our doctors who are in some of these fee-for-service, more concierge-style practices, they're calling the patient the night before or the day before to do that final reminder call and giving that added level of commitment.” (8:40—9:36) -Miranda

“It's really important to look and say, within this new patient system, do we have it documented? Do we know what we do when a new patient is unconfirmed? If I'm the patient coordinator and we have this automated process, it goes out two weeks ahead, it goes out five days ahead, it goes out three days ahead, and they still haven't replied with that “C” or the “1” in their text message, and it's sitting there in the unconfirmed color in your practice management software, and it's tomorrow, and it's a two-hour block, what do we do? Do we just say, ‘I hope they show up’? Sadly, a lot of practices do. Or do we have a plan that says, ‘Okay, at 24 hours out, if we've already had these three automated reminders, we made a personal phone call and we got nothing back, and we don't have paperwork yet, nothing has been submitted, do we have a process of releasing that appointment? I love the idea of sending a text and leaving a message that says, ‘Patient, we've tried to reach out multiple times. We were so looking forward to meeting you. Because you were unresponsive, or we were unable to make a connection with you, we're going to release this appointment time. However, we'd love to hear back from you to find another time that we're sure you can commit to.’ And now, we've contacted them in every way possible, but we've set ourselves up for the ability to recover that time. We're not waiting and going like, ‘Well, nothing we can do now. They're not here, and we can't call somebody in to fill this time in the moment.’ So, I think it's good to build that in as part of your system.” (9:38—11:13) -Miranda

“You might say like, ‘Well, they don't even answer when I call. Why am I doing this?’ They get that message and they're like, ‘Holy cow. That wasn't the administrative team member or a virtual assistant. That was the doctor that just called me.’ The number of times, in my own experience, that I've had patients come in and say like, ‘The doctor actually called me last night. I got that message and I couldn't believe it,’ and it's like, ‘Yeah, that's the type of care and attention that you can expect to get here. The doctor genuinely cares about every single new patient.’ That does set you apart from the places that you go as a patient where you're just one of many.” (12:21—12:56) -Miranda

“The other thing that people will sometimes ask is like, ‘Wait, you've done this? You've actually released new patient appointments? What if they show up?’ Well, here's the thing. Ninety-five percent, if not more, of the time they don't show up, they were never going to, and they don't. When they do — which, it's happened to me one time. I remember sitting in the exact seat I was sitting in. All I said was, ‘Oh my goodness, Mrs. Jones. I have been trying to reach you for the last two weeks. Please take a minute. We did release your appointment. I sent you a text. I sent you an email about it. I left you a message. Can I confirm that I have the correct information? Maybe I wasn't sending that to your correct email. Do you have a preferred method of communication?’ And they usually pull the, ‘You did not message me.’ They pull it up, and they go, ‘Oh, yeah. I do actually have a message from you right here.’ And you're like, ‘Oh, okay. Well, that's the right number, then? Great. Let's make sure all this is good to go. Let's find you another time.’ They'll be fine with it, and it's going to happen one out of 99 times.” (12:57—13:57) -Miranda

Snippets:

0:00 Introduction.

2:19 Why this is an important metric and how it impacts the practice.

5:41 What you can do to impact this metric.

14:41 Final thoughts.

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.
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