What is your views on charging a cancelation/ disappointment fee?

[kerrydds06]

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Personally I feel I should charge $100 cancelation fee if not given 48 hour notice.
This creates value for your time.
I understand there may be true "emergencies" and i will refund if they show to the next appointment, but if patients know they will be billed $100, they will make every effort to show up.
Clear communication of the policy will allieviate stress on both me and my staff. and allow us 2 days to fill the space.


What are your views?
Any literature out there on the subject???

 

[toofache32]

That's a tough one. Some people do it. Hotels do it. I'm not sure that it doesn't just piss off your patients. They don't see it as a "business" like we do, unfortunately.

 

[rocknightmare]

as a young patient with very unpredicable schedule i like the option of canceling at anytime, i let my doctors know that if you schedule me 6months in advance you will probably not see me (i am a terrible patient!), but if i do the scheduling within one week time period i usually show up on time.

 

[12YearOldKid]

as a young patient with very unpredicable schedule i like the option of canceling at anytime, i let my doctors know that if you schedule me 6months in advance you will probably not see me (i am a terrible patient!), but if i do the scheduling within one week time period i usually show up on time.

You will defnitely change your mind when you start seeing patients. There is nothing more frustrating than setting aside a significant portion of your day for somebody and they don't even have the courtesy to show up.

I don't know if I will charge patients a cancellation fee when I have my own practice. I think it probably just ticks people off more than anything. Some docs will waive the fee the first time and use the situation as a way to explain the importance of showing up for appointments without coming across as a jerk.

I have also heard of dentists who will charge patients a no-show fee, but also offer a credit in the same amount to patients who have to wait more than 15 or 20 minutes to be seen. Sort of a "you respect my time and I'll respect yours" situation. I like the idea but wonder how it works in practice.

 

[12YearOldKid]

I am very harsh with my patients at school who no-show or cancel the morning of an appointment. I will usually give them a chance if I like them. But if they no-show their first appointment or no-show more than once I will give them the boot without even a second thought. And they do not get the option of being seen by another student; they are out of the school program.

I am paying ~$60 per clinic session for the privilege of doing their dental work. (You people at other schools are probably paying 2-3X this.) When they don't show up not only do I get an F for attendance that day, I have wasted time and money on them. If they can't respect me enough to show up for appointments they can just live with the filthy, stinky pit of decay they have created. And it always seems that the worst patients are the ones who need your services the most -- go figure.

 

[toofache32]

I am very harsh with my patients at school who no-show or cancel the morning of an appointment. I will usually give them a chance if I like them. But if they no-show their first appointment or no-show more than once I will give them the boot without even a second thought.

At my school we had to document 3 no-shows (or cancel within 24 hours) before we could give them the boot. That was really frustrating because sometimes you knew you had a deadbeat, but we were obligated to waste 3 appointments to be done with them.

 

[aphistis]

The best approaches I've heard involve making the cancellation fees a policy, but enforcing it pretty selectively. I've had pretty good luck with my patients so far, and as long as they're an otherwise good patient, I don't mind giving them a mulligan. So far, my few late cancels/failures have all bounced back on track after a phone call.

Also, at IUSD, chart inactivations are at the clinic director's discretion. My director is awesome about backing us up on patient management issues.

 

[kerrydds06]

I am very harsh with my patients at school who no-show or cancel the morning of an appointment. I will usually give them a chance if I like them. But if they no-show their first appointment or no-show more than once I will give them the boot without even a second thought. And they do not get the option of being seen by another student; they are out of the school program.

I am paying ~$60 per clinic session for the privilege of doing their dental work. (You people at other schools are probably paying 2-3X this.) When they don't show up not only do I get an F for attendance that day, I have wasted time and money on them. If they can't respect me enough to show up for appointments they can just live with the filthy, stinky pit of decay they have created. And it always seems that the worst patients are the ones who need your services the most -- go figure.

As mean as it sounds I agree.
How did you come up with the $60 number? Divide tution by # of days?


I came up with the $100 Cancelation fee: overhead(200,000) divided by 50 weeks = $4000 divided by 40 hours = $100 per hour it cost me to open my doors.

 

[drhobie7]

I agree with the hard ass/tough love approach. Your patients are like little kids. You need to train and discipline them. *WHACK!* as I smack the ruler down on the desk. However, you also need to explicitly state your expectations from the first appointment. This includes even the seemingly obvious, because you never know what they're thinking.

 

[SMC2UCLA2_]

I agree with the hard ass/tough love approach. Your patients are like little kids. You need to train and discipline them. *WHACK!* as I smack the ruler down on the desk. However, you also need to explicitly state your expectations from the first appointment. This includes even the seemingly obvious, because you never know what they're thinking.

Thats what both my dentists do and it works well. There is a $100 dollar cancellation fee and the times that I forgot to show up they both called and asked why I didn't show up and said that their policy is $100 dollar charge. I apoligized and said I totally forgot and I was under a lot of pressure and they both said to not make a habit of it and that they would let it go this time.

I think it works well, I never missed another appointment.

 

[jpollei]

I am very harsh with my patients at school who no-show or cancel the morning of an appointment. I will usually give them a chance if I like them. But if they no-show their first appointment or no-show more than once I will give them the boot without even a second thought. And they do not get the option of being seen by another student; they are out of the school program.

It may be worth stating the obvious here...that this is a great way to get clinic requirements finished up by the end of your third year, too.

 

[toofache32]

It may be worth stating the obvious here...that this is a great way to get clinic requirements finished up in three years, too.

In dental school, I always presented the situation as "us against the school." I told the patient that if they didn't show up for their appointments, "the school wouldn't let me do their work any longer." In reality, I was the one tossing them in the trash, but it worked.

 

[aphistis]

As mean as it sounds I agree.
How did you come up with the $60 number? Divide tution by # of days?


I came up with the $100 Cancelation fee: overhead(200,000) divided by 50 weeks = $4000 divided by 40 hours = $100 per hour it cost me to open my doors.

If you're at the office 250 days a year as a dentist, you're working way too hard. 😉

 

[kerrydds06]

If you're at the office 250 days a year as a dentist, you're working way too hard. 😉

I wanna work hard the first few years, while I still have energy and building the practice, as my son grows older, i want to be able to take more time off. 250 days out of 365 isnt bad.
As I become more efficient, I'll scale back, Take Mondays off eg.
For now I'll make Hay while the Sun Shines.

 

[ItsGavinC]

You will defnitely change your mind when you start seeing patients. There is nothing more frustrating than setting aside a significant portion of your day for somebody and they don't even have the courtesy to show up.

100% agree. After treatment planning (you know what that means, going over the plan with every specialist and getting 30 different opinions), laying out supplies, telling other patients that the schedule is full, etc., nothing makes me angrier than a no-show. Right behind the no-show is the cancellation. I've had patients cancel at 12:40 for a 1 pm appointment.

 

[Rube]

A dentist should never be directly involved in the enforcement of the cancellation fee. That is why you pay for savy front desk help. She/he is the one who informs the patient they will be charged "25 for last week". Notice I did not mention "dollars" I said "twenty five." It sounds much nicer. Also I didn't mention the broken appointment. I referred to it in a roundabout way as, "last week" so as not to restart an argument with the patient or get them defensive. They know and so do you.

It all comes down to how you say it, not just what you say.

 

[aphistis]

100% agree. After treatment planning (you know what that means, going over the plan with every specialist and getting 30 different opinions), laying out supplies, telling other patients that the schedule is full, etc., nothing makes me angrier than a no-show. Right behind the no-show is the cancellation. I've had patients cancel at 12:40 for a 1 pm appointment.

Absolutely.

Had a patient just this morning who failed a pulpectomy appointment. This lady has had a throbbing toothache for over a week (I pulped it excavating caries, so I know it's a legit toothache), and still doesn't show up.

I couldn't figure out why she'd fail, until I remembered that my clinic director changed the pain Rx I asked him to call in, from 24 Tylenol #3 to 72(?!) Vicodin, without asking or even telling me. I can't imagine what prescribing a month's worth of narcotics might have to do with her not showing up, can anyone else? 😎 👎

 

[toofache32]

... I've had patients cancel at 12:40 for a 1 pm appointment.

That's a no-show in my book, and at my school.

 

[toofache32]

A dentist should never be directly involved in the enforcement of the cancellation fee. That is why you pay for savy front desk help. She/he is the one who informs the patient they will be charged "25 for last week". Notice I did not mention "dollars" I said "twenty five." It sounds much nicer. Also I didn't mention the broken appointment. I referred to it in a roundabout way as, "last week" so as not to restart an argument with the patient or get them defensive. They know and so do you.

It all comes down to how you say it, not just what you say.

Spoken like the voice of experience. Are you in practice?

 

[toofache32]

...Vicodin...I can't imagine what prescribing a month's worth of narcotics might have to do with her not showing up, can anyone else? 😎 👎

Acetominophen-induced liver failure maybe? Happened to me here in residency.

 

[Rube]

Spoken like the voice of experience. Are you in practice?

Not for 3 more years, but I've worked front desk in a very good, high income practice and that's how you keep you keep your patients and keep respect for your time.

 

[jpollei]

... nothing makes me angrier than a no-show.

Ah, just slap 'em the next time you see them. You might lose a patient (though there's no telling if they'd actually show up again anyways), but you feel a whole heckuva lot better. 🙂

 

[dinesh]

I think it works best as a deterant rather than a punishment.

People would tend to be courteous if they know there is a fee attached to their lazyness to pick up a phone.
Emergencies aside of course.