Every office has those patients that either show up late or miss appointments again and again. You know who they are. They might tell you they are very sorry, but something came up at the last minute. They might not appear to feel bad at all. Whatever the reason, it happens continuously, and they cannot be trusted to keep an appointment.

These are the patients that you should never pre-appoint. Pre-appointing patients is an excellent recall habit that increases retention, but not everyone deserves the opportunity. It should be a privilege reserved for your compliant patients – those who value your service and that you can trust.

Aim to pre-appoint no less than 75% of your patients but not 100%. There are just some patients you should never provide this convenience. Your perpetual appointment breakers fall into this category.

Each practice needs to decide how many missed appointments they will tolerate before they stop pre-scheduling. In some practices, one no-show will put a patient on the same-day-appointments list. Other practices will allow two or more missed appointments. Keep in mind that there is a difference between a patient who misses two appointments in ten years and a patient who misses two appointments in one year.

How Do You Identify Continuous Appointment Breakers?

You need to have a system that enables you to track no-shows. First, make sure that everyone in your practice is on the same page about managing failed appointments in your scheduling software. If a patient cancels their appointment without adequate notice, this appointment should be marked as broken, not just deleted or moved to another day.

Mark late notice cancellations and no-shows as broken in your scheduling software to allow your team to track patients with a poor attendance record. When you do this, a glimpse at the patient’s profile should tell you exactly whether you are dealing with a patient you can trust.

YAPI reads broken appointment history in your scheduling software and informs your team when a patient has a history. If you see this alert  on the Practice Dashboard or the Daily Huddle Report, mouse over it to view the patients' history and decide whether to pre-appoint them.

Should You Charge a Broken Appointment Fee?

Some people are just wired to be late, forgetful or dismissive of another’s time. They are the same individuals who miss deadlines at work and forget to pay bills. Charging a broken appointment fee is not going to change them. Instead of threatening with a fee, it’s best not to pre-appoint them in the first place. You need to take control.

What to Do When You Have a Perpetual Appointment Breaker:

• Put them on a short call list for when you have last-minute openings. They should never have reserved time on your schedule.
• Opt these patients out of automated confirmations. It is much easier for them to ditch a robot than the lovely Christine who always greets them at the front desk.
• Talk with them about their schedule. Explain to them that since they seem to have a busy schedule that causes them to miss appointments, you will keep them on your call list to contact when there are last-minute openings.
• Add value to each visit. Provide top quality care when they are at your office.
• Stay on time for your patients. We all fall behind schedule occasionally. Unfortunately, when patients end up waiting at every visit, they may decide that the practice does not value their time and wonder if anyone would even notice if they didn't show.
• Educate them about the importance of oral care and about any treatments they might need.
• Exercise strong verbal skills. Be kind but firm. Make sure they understand that broken appointments are simply not tolerated in your office. Be sure to answer any questions they have, smile, make eye contact and be nice.

Should You Ever Give Them a Second Chance?

Yes, your “perpetual appointment breakers” can end up becoming a loyal patient. When they are due for an appointment and you give them a call, they show up right on time. They show you respect in the chair and maybe even refer others to you. As they continue to return for recall, it is clear they understand the importance of maintaining their oral health.

When you see these positive changes, you may decide to give them a second chance. Go ahead! Just keep a close eye on these appointments and remember that if they break your trust again, they stay on the same-day-appointment list.