Patients Are Kind of Like Pets

My dog begs. It’s no surprise–I trained her to do it.  It was easy. I barely had to spend any time doing it.  She also sleeps on the couch.  That was even easier to train her to do. I just allowed her to do it, and I was done!

This isn't my dog--it's a kangaroo.  Get real!

This isn’t my dog–it’s a kangaroo. Get real!

Very often, we complain about how patients behave, when in reality we taught them, or at least allowed them, to behave that way.  They cancel appointments at the last minute, they pay us when and if they feel like it, they make us contact them three times to confirm an appointment, they complain that their insurance doesn’t pay for everything, they get two years behind in their cleanings, they wear temporaries for six months.  You know what I’m talking about.

It takes more time and effort to train your dog to respect your dinner, and your carpet, and your couch.  But it’s usually worth it.  Same thing with patients.  My personal opinion is that there should be no such thing as accounts payable in a dental practice. Get paid for what you do when you do it. (I know, sounds craaaaaazy!)  For decades, we have trained patients that we will bill them later.  Many of them will even pay that bill. But I know many practices that are now getting the fee handled at chairside before starting the procedure. It can be done, and you end up getting 100% of your money.  You may not be ready for this, but in any case patients should never leave the office with a balance.

This same principle of retraining applies to missed appointments or last-minute cancellations. Hey, we all lead busy lives, and sometimes something comes up, and we all deserve a pass now and then.  But you know who your abusers are, and they are putting holes in your schedule that you can’t fill.  Now, I don’t believe in charging for missed appointments. That just loses the money and the patient.  But with your patients who take a casual view of your schedule, after the second time it happens I would tell them that you can no longer hold appointments for them unless they pre-pay.  You’re happy to call them if you have a last minute opening (from some other “casual” patient), but tell them that without enough notice, they are preventing you from taking care of other patients who need treatment and can show up, and show up on time.

I know that it’s hard to train existing patients who already have the wrong behavior.  So why not at least start with your new patients? Train them the right way from the first visit. Within a year or two you will have had a significant impact on the activity in your office, and most likely in your productivity as well.  You’ve only got so many hours a week to treat patients, and every gap in the schedule is a treatment you can’t do and revenue you won’t generate.

So decide how you want your ideal patient to behave, and reinforce that good behavior by giving them great care.  Don’t make me send you a new puppy.


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8 thoughts on “Patients Are Kind of Like Pets

  1. I have considered requesting credit card info to hold appointment time. How do you feel about that, Fred? Nice post!!

  2. Love it! I wrote a similar blog a few months back. You ABSOLUTELY CAN retrain your patients-we did it.
    I totally agree that it’s easiest to start with your new patients…that’s why I’m so passionate about using different language with them so they immediately understand that we are SERIOUS about seeing them at their reserved time.
    As far as requesting credit card time to hold appointments. We’ve been doing it for YEARS. It is possible to do and people WON’T be offended..if you do it correctly.
    Our patient attendance rate has only improved since we implemented a few key strategies. Last month, we had 98% attendance, we definitely didn’t have that back in the day.
    I always tell people, you can’t just cross your fingers and HOPE that people show up and pay, you have to FOLLOW specific strategies to make that happen.

  3. First off that is one interesting dog you’ve got there!! It all makes perfect sense, the most important piece of the puzzle is staff training/scripting. Everyone has to be on board.

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