How Patient Communication Strategies Reduce Dental No-Shows

Dental practices around the country face a major problem. Whether you run an insurance-based practice or a fee-for-service clinic, patient no-shows waste valuable chair time, regardless of whether a patient has paid or still owes a balance. The solutions vary. Simple changes in your messaging, communication channels, personalization, tone, and team training mean the difference between a full schedule and sudden, empty chairs you have no ability to fill. 

Why the message matters as much as the channel 

We have many ways to communicate with each other in today’s world of high-end technology.  When we communicate with our patients, we may start the patient-office scheduling interaction in-person at the end of their current visit, on a new patient or follow up scheduling phone call, in a text message, through email, in a letter through the postal system, or a handful of other ways.  With so many options, the message your patient is receiving is just as important, if not more so, than the way they are receiving it.   

Unfortunately, your patients may not realize how important it is for them to not only show up for their appointment but to also show up on time.  Our message during scheduling needs to be concrete and ensure they know the importance of their visit.   

For example: “Thank you so much for scheduling your next visit on Tuesday, January 8^th at 4pm.  We have reserved this time specifically for you and intend to complete treatment during the visit.  You’ll be here for one hour, and we do need that full hour to complete treatment.  Please make sure that you arrive on time, and we will make sure that we start your treatment on time as well.  It is always our goal to commit your precise appointment time to you so that your visit is our top priority.  If any issues arise that would hinder your ability to arrive on time or at all, please let us know as soon as possible and we can work to accommodate your needs for a different visit on that day or another.”   

Different versions of this message can be sent through text, email, or phone message.  However, the message should be the same across every channel.  We have reserved a visit for you that we have made our priority.  Please also make sure it’s  your priority to be here.  If there are fees due at the visit, mention that as well.  Ensure the patient has all the relevant information and will be ready to go upon arrival.   

Personalizing communication by patient type (new patient, recall, high-value treatment) 

In general, no-show risk tends to look like this: 

• A new patient is the practice’s most likely type to no-show.  The entire relationship is currently built on likely just one phone call.   

• If they are a referral patient, they are more likely to show up than if they found you through your website but it’s still far from a guarantee.   

• If this is a same day appointment, you must communicate with the patient through the initial channel but also add a text and possibly even an email.   

• If your office has the patient’s complete forms ahead of time, this will also be an indicator as to whether they plan to attend the visit.   

Your recall patient will be more reliable.  This is likely a long-time patient or, at the very least, someone is in the process of continued care.  Find out their preferred method of contact and make sure you send a recall card in the mail, an email confirmation, a text message, and possibly even a phone call.  The chance of a no-show is more likely because the appointment was scheduled 3-6 months ago rather than because they don’t  intend to attend.   

Your high-value treatment patient is the most likely patient to show for their visit, on one condition.  Have all the financial arrangements been made?  High-value treatment is often missed because a patient simply can’t afford the treatment and is embarrassed to say something.  Unfortunately, these are also the longest appointments in your schedule book and the biggest void to fill for a no-show appointment.  Contact this patient directly by phone or text, and ask for confirmation.  Ensure that all questions are answered and financial arrangements are locked in.   

Tone that builds commitment instead of feeling transactional 

Dentistry is a business.  The doctor-patient relationship is transactional in the sense that the patient is paying for treatment, and the doctor is completing the treatment.  However, the patient shouldn’t think the doctor is doing the treatment only because there’s payment involved.  As healthcare workers, a doctor and his team should be clear that the patient’s health is of the utmost importance.  “We are committed to providing you with the best care in the most comfortable environment.  Our expectations are merely that you show up for your appointment as scheduled and ask any questions or relay any concerns before, during, and after treatment.”  We all prefer a long-term relationship with our patients, and they need to feel that in the way we speak. 

Training front-desk and call-center staff in consistent messaging: 

If your team doesn’t  know the best way to deliver your message, then how much does the message mean?  Every office needs to have a script in place for everything they do.  When messaging is consistent, your patients can’t tell you, “No one told me that” or “how was I supposed to know.” If you train your team to share a consistent message, then the issue becomes the message being lost in translation rather than the message not being relayed.   

A script that gives your patient every detail of their next visit and just fills in the blanks for personalization goes a long way to reducing your no-shows.  Your script should account for reaching a patient on the phone, leaving a voicemail, or sending a text message.  You may want to incorporate using multiple methods for patients who are at higher risk of skipping their visit.  Providing all the information such as time, treatment, and cost will reopen discussion for any type of objections or a cancellation if the patient was not planning to show up.   

Train your employees regularly on the script.  If they have worked for you for a week or twenty years, they should still be training and roleplaying your office scripts.  Always be open to change, and rewrite if things are not working.   

The moments that matter most: booking, pre-visit, and post-miss follow-up 

There are three main stages to a missed appointment.   

The first step is the booking process.  Was your message concise?  Did the patient have all the relevant information?  Did your office give the patient an immediate reminder of their next visit?   

The Second step is the pre-visit.  This occurs during the time between booking and the upcoming scheduled visit.  Did you contact the patient to confirm?  What methods did you use to confirm? Were all financial arrangements made? 

The final step is following up with the patient post missed visit.  How long did you wait to call after no-show? Is there a fee for no-show?  Do you have a different process to reschedule?  Was this all clear during the booking process? 

What else are you doing to fix the patient’s no-show problem? We can all use messaging, tone, communication channels and training to lower no show rate.  However, the nature of the business is that there will always be patients who miss their appointments.  Figure out the best methods to keep your chairs full that also leave your patient feeling properly cared for.  Be clear with your needs, but be compassionate to theirs.  Consistent communication in both directions will lead to a long and prosperous doctor-patient relationship.