By Dr Richard Mitton
Some practices have found that missed appointments or last minute cancellations can account for as much as 10% of their total scheduled appointments for the day. Cancelled appointments can be a significant frustration for the whole team, it can financially eat into the profits, prevent other clients from being able to utilize that time slot, and more importantly puts clients off their schedule of care.
Practices who have relatively no missed appointments and cancellations are the ones who have a high level of Faith, Confidence and Belief. They give their energy to clients in the practice rather than “worrying” (praying for something you do not want), about clients missing or cancelling. In these practices the pre and post shift review (team huddle) concentrates and gives positive energy to the clients they serve rather than foreseeing or analysing missed appointments.
To minimise cancellations, take the term “cancelled appointment” out of your vocabulary. There is no such thing as a cancelled appointment. Clients might ring to “reschedule” an appointment (even if that’s not the terminology that they use) and if they can’t reschedule, they are “on recall”, not “cancelled.”
To remain in integrity, don’t create a policy that you are not prepared to hold a client to. Whether that entails fees, make-up appointments, or both. Not doing what you say you will, only undermines your credibility in other areas. If you have such a sign up in your office and you don’t charge the fee, please, take down the sign!
The best re-schedule policy that I have seen work, generally incorporates the following:
- A written document that outlines your expectations and the consequences that will come about if the client does not fulfill their side of the deal. This needs to be balanced by an outline of the commitments that the practice will also uphold.
- During the Chiropractic Assistant report, use the clients name with eye contact and pause to confirm the client has understood any policies and will adhere to them. Eg adhere to giving 12 hours notice.
- Don’t call it an “office policy” – people generally shy away from policies. Call it “How We Do Things Here” or “Our Mutual Agreement”.
- If the client rings to “cancel” or reschedule after that time but still before their adjustment, first ask if everything is OK and they will usually tell you why they are unable to keep their appointment. Acknowledge that you have heard them and understand. Explain the importance of their schedule and offer two appointments later on the same day or the next day to, most importantly, keep their health on track. Always give them the either/or option of appointment times, that minimises the “no” response and fits with block booking your adjustments.
- The reschedule policy is generally given to all clients to read with the fee outline on the first or second visit. We believe that the best procedure is to go over the policy with them after their report of findings (a “CA report”) or on their 3rd visit.
- If you choose to charge a fee, explain that you charge a cancellation/missed appointment fee to help ensure they stay on track, and that they don’t use a time where you could be serving other clients in need. Ask the client if they understand or have any questions (pause).
- Getting the client to sign or initial all agreements is THE BEST way to enforce the reschedule policy (or any others that you have). Make sure your team are totally congruent with these procedures and practice them until you have them down-pat. Don’t practice until you get it right; practice until you can’t fail.
Most chiropractic practices believe in a preventative approach to health care. Why not do the same with your appointment book? Be prepared to listen to your clients, have a set policy that you adhere to, book full schedules ahead and print out calendars for your clients.
In your goals and team huddles put out positive energy and celebrate your clients keeping their schedules.