Building the Foundation

Transcription

1 Stop Cancellations! How to Deliver Total Patient Service AND keep your schedule under control. A Special Report by and CrownCouncil.info TotalPatientService.com ToPS 1

2 Building the Foundation Why the Problem is t the Problem Like so many things in life and in dentistry, cancellations are not a problem! They are just a symptom. For example: there is no such thing as a collections problem. It is just a symptom of a bigger problem with financial arrangements. If there is a good financial arrangements system in place then there are few collections problems. Or how about this: there is no such thing as a seat problem with lab work that consistently does not fit. But there may be an impression problem in the office or casting problem at the lab. A crown that does not fit is just a symptom of a bigger problem. So quit thinking of cancellations as the problem. It s not! The problem lies with the over all system you have in place to help patients accept and stay committed to treatment. If you have a lot of cancellations, don t try fixing the symptom, try going back and taking a look at the cause - the case acceptance system you have in place. (If you have one!) If you are going to solve a problem, you have to go back to its very roots its origin. The foundation of a solid case acceptance system, which helps patients commit and stay committed to treatment, starts with every team member having a clear understanding of the purpose of the practice. If you don t know why you are there in the first place, it is not likely you ll do a very good job of it. So start asking your team the tough questions. The next time you have a team meeting, ask them what the purpose of the practice is and then just shut up and listen! At first, the silence may be deafening! The answers may be as varied as the team members you have in the practice. But until everyone is on purpose, your practice results may be just as varied. Why the Problem is t the Problem In short, everyone s purpose should be to create happy, paying patients who pay more that it cost to serve him or her and repeats and refers. Imagine the difference it would make to focus on patient commitment not just appointment book control at the front desk. Or how about every clinical assistant focusing on long-term patient relationships with the practice, not just organizing instruments and taking x-rays. How you view your job, causes behavior that creates results with patients. So don t just start working on the surface problem by trying to fix a symptom without first checking to make sure the foundation is in place. TotalPatientService.com ~ ToPS 2

3 A Fundamental Philosophy Once everyone on the team understands their purpose, then you better wake up to the next fact: your patients don t come trained when they show up to your office! Most patients have experienced so much abuse of their time in medicine and have been treated so much like a number or health insurance policy instead of as a person that they have subconsciously come to expect something similar everywhere they go in healthcare. Because of that, everyone on the team needs to understand that you have to teach your patients how to treat you. They don t come trained. It starts by treating them with respect and courtesy and asking for and expecting the same in return. You communicate those expectations every moment you interact with them from the first conversation on the phone to the last good-bye as they walk out the door. It is a funny thing in life, we often get what we expect because our expectations influence our behavior and our behavior creates results. What s your system? Creating a committed patient who follows through and doesn t cancel is more than just a grab bag of miscellaneous tactics. It is about having a comprehensive system that you and your team use every day to get consistent, predictable results with your patients. So what s your system? If cancellations flair up, do you just look at your administrative team and tell them to pull it together. Or do you look at the entire system you have created with your team to keep patients committed to treatment and see where the breakdown is? If you don t have a system, then you are totally dependant on the people in your practice to make it up as they go along every day and do the best they can. That s not good for your practice. It s not fair to your team. And it is only frustrating to everyone involved. What s your system? 1. Discuss and define the purpose your practice with your team. Until everyone on the team is saying the same thing, you won t have any hope of seeing them doing what it takes to get and keep committed patients. 2. What do you need to do to teach your patients how to treat you? How are you training them today? What are your real expectations and how do you communicate with them verbally and non-verbally? 3. What s your system? Start working together with your team today to define and fine-tune the system everyone will use to gain and retain happy, healthy, committed patients. CrownCouncil.info ~

4 Who s most at risk? Hygiene Patients: They may think: It s just a cleaning. New Patients: They may feel anonymous and say to themselves: one knows me. Financial Flu Patients: Patients who get sick the day of treatment because of payments due. Team Commitment: We teach patients how to treat us. That is accomplished in a positive way, not a negative way. Reward good behavior and set positive expectations of your patients in advance. Stop Cancellations Rule: Patients place as much importance on their appointment time as YOU do. TotalPatientService.com ~ ToPS 4

5 Prevention: 80% of the solution comes from preventing the problem in the first place. Set your patients up to succeed in your practice. 1. New Patient Welcome Call: Appointment coordinator prints out a list of all new patients scheduled for the following day and gives it to the doctor at the morning meeting. The doctor calls each one the day before their appointment. Doctor: te: This does not replace the Appointment Commitment Call (see #5 below) that is placed by the administrative team two days before the scheduled appointment. CrownCouncil.info ~

6 2. In the Treatment Room: Doctor conversation with new patients or patients who will be coming back for several appointments: Hygienist conversation with patients of record (at every appointment): - - (Recommit every patient at every appointment to his or her continuing care.) TotalPatientService.com ~ ToPS 6

7 3. Keep The Chain Connected with a Strong Relationship Link. Connect the clinical relationship to the administrative relationship. Communicate: Planned and agreed upon treatment. Patient s P.I. (Primary Interest). Any patient concerns or potential obstacles. Ask the patient: Is there anything I missed? Dental Assistant talking to the administrative team member, while standing next to the patient: (Primary Interest) (Concern) Administrative Team Member to ask: (Give them a choice of the days you are available.) Hand the blank appointment card or postcard to the patient and let them fill it out. It has more power if it is in his/her own handwriting. CrownCouncil.info ~

8 Appointment card suggestions: Eliminate all language that has penalties or guidelines for cancelling an appointment. Instead, the card might say: Missed Appointment and Cancellation Policy If you are unable to keep a scheduled appointment, please give 24 hours advance notice, to ensure that you will not be charged for the appointment. If less than 24 hours notice is given and we are unable the appointment, Thank you. 4. Get a Verbal Commitment from the Patient for the Scheduled Appointment: The two most powerful words when scheduling an appointment: Example: TotalPatientService.com ~ ToPS 8

9 5. Appointment Commitment Call: Give your patients the option of which method of communication they prefer when receiving messages from you regarding their upcoming appointment: phone call, text message or message. Have the appropriate technology in your practice to accommodate their preference. When calling, ing, or texting to assure the patient s commitment to their upcoming appointment, eliminate these two words from your vocabulary: Confirm & Remind Suggested dialogue or message: This call should be made two days in advance for new patient so the doctor can make the welcome call the day before the appointment. If the new patient is coming in sooner, coordinate the calls in the morning meeting. For hygiene appointments: CrownCouncil.info ~

10 6. Electronic Communication Apps While text messaging and have made patient communication easier, they don t replace the personal touch that comes with a quality dental experience. Dentistry remains a relationship business. The more relationship you have with your patient, the more long-term, loyal patient you will have. Never allow that relationship to become strictly transactional. matter the app, it is the content that influences patient behavior. A high-tech app with the wrong message will destroy the schedule and the quality of the relationship. Every word of communication, no matter the channel, should flow toward desired, positive patient outcomes. In the realm of scheduling, this means: Patients in the chair for first appointments every time, Hygiene appointments on the books and conscientiously kept by patients, and Restorative and seat appointments regarded by patients as high priorities. Though the technology and channels of communication keep changing, the words and underlying messages remain quite consistent. This is all about training patients and teaching them the right, responsible way to treat you. You show the way by establishing high expectations for both sides patients and professionals and living up to them. Right at the beginning of the patient relationship, inquire about the patient s preferred method of communication voice, text, , or yes snail mail, or a combination thereof. te the preference and save it into your practice management software, so the channel is correct for each patient. To each patient, their own channel. TotalPatientService.com ~ ToPS When scheduling an appointment with any patient, remind them about their preferred method of communication, and that they will be hearing from you based on their selection: With your permission, we will send you periodic updates regarding your appointment, so we stay in sync. Once it s scheduled here, it s set in stone. That way you can plan on it. When you follow up electronically regarding their scheduled appointment, all the same rules regarding verbal communication still apply. Patient contact programs get it all wrong by providing or response options for appointment confirmation. This is an open invitation to cancel, with no embarrassment involved, because your patients are dealing with a machine! Stay in control of your own electronic messaging by crafting your own: We look forward to seeing you on (day, date, and time) for your dental appointment. If there are any questions regarding this appointment, please call the office at: Do not I repeat not make it easy to cancel, with only remote push-button responses. If there is a serious issue, as there sometimes is, direct voice communication is the rule in your practice. 10

11 First Aid: What to do with the exceptions or those who call to cancel or change their appointment. Pre-requisite: Quit saying when the patient makes a plea for your sympathy by saying I m really sorry but I need to cancel my appointment. Instead, be firm and friendly. Follow this verbal skills outline: 1. Listen and don t react. Take a deep breath and just say 2. Ask them to hold while you get their records. (Go get the chart or look it up.) 3. Ask for a re-commitment: (scheduled treatment) (Her Primary Interest)! 4. If not: 5. Last resort: (If they won t reschedule and they won t tell you why.) 6. Frequent offenders: For patients with hectic schedules that change frequently, consider putting them on your Same Day Appointment List and get their approval to call them with short notice on the day when you have time available. TotalPatientService.com ~ ToPS 11

12 Voice Mail Message: Which day of the week is the most dreaded day in the dental office? MONDAY, because patients call for two or three days over the weekend to cancel their appointments. Make it easy for them to do what you want them to do and hard to do what you don t want them to do: Suggested answering machine message: CrownCouncil.info ~

13 Frequently Asked Questions About Cancellations and Shows: Q - Should we charge for missed appointments or have a cancellation policy? A - and no! A poorly written cancellation policy can send the message: We don t have very many patients that respect our time so we really have to sock it to you if you cancel because we have so many that do! Our preference is to train your patients how to treat you. Most of us will rise to the expectation given. There are some target markets that need a firm but friendly cancellation policy. You might print it on the appointment card you give them when they schedule that says: - You decide what policy makes the most sense for you. TotalPatientService.com ~ ToPS 13

14 Q - Should we send appointment reminder cards? A - If your patients are in the habit of receiving an appointment reminder card from you then don t quit until you have them trained to expect something different. Look carefully at the message that is on the card. Many preprinted cards have a note that has a cancellation invitation on it like, Appointment changes within 48 hours of the scheduled time will be charged at the regular fee. All this does is say that it is OK to change or cancel your appointment as long as you give enough notice. It is your decision, but it is easier in the long term if you teach your patients that you expect them to keep their appointments as originally set. If you do use reminder cards, have the patient fill out the card themselves when the appointment is set so they will recognize their own hand writing when it shows up in the mail. The language should say: Q - Should we call to confirm appointments? A - Have you been doing it to this point? Don t stop doing something if your patients have come to expect it. Unless you have trained them to expect something different, you have to be consistent. Here are some verbal skills suggestions when you do call. Eliminate the word confirm from your vocabulary. It just gives the patient an opportunity to get out of the commitment. Confirm implies that it was not firm to begin with. Q - What about digital reminders? A - Set up a system to give your patients a choice of how you communicate with them. Do they prefer a post card, call, text, or ? There are so many ways to communicate today that individuals have preferences. Find out how they operate the best and accommodate accordingly. CrownCouncil.info ~

15 Q - What should we do when someone doesn t show up? A - Call them within 5 minutes of their scheduled appointment. If you can t find them, leave a message that says something like this: Be sensitive to potential extenuating circumstances. Don t automatically assume that they have not shown up for frivolous reasons. Q - What should we do with repeat offenders or those who always want to change their appointments? A - In most cases, they do what they do because you have allowed it. Remember, you teach people how to treat you. If the problem is recurring, you might want to say, In very bad cases, here is a suggestion: At a certain point, it does not make sense to keep spending time on someone who is not going to change. You may be afraid of offending the patient; however, in most cases the patients who give you the most hassle are the ones who are not profitable for your practice anyway. Furthermore, they associate with people just like themselves who would not necessarily be good patients either. Be firm but friendly and remember whose practice it is! TotalPatientService.com ~ ToPS 15

16 Checklists: What is Your Cancellation (Symptoms) Score? 1. Are you canceling or moving your own patients as the rule versus the exception? 2. Are you running late, more than on occasion, and disrespecting patients time? 3. Are you seeing patients who show up to their appointments late without addressing their lateness? 4. Do you have unclear case presentations with no real commitment made by the patient? 5. Do you ever schedule a patient without firm financial arrangements? 6. Are you allowing patients to cancel and reschedule with no consequences? 7. Do you typically have 1 or more no shows per 8 patients in hygiene? 8. Do you typically have one or more last minute schedule changes in a day of hygiene? 9. Do you have one or more no shows in the Doctor s schedule per day? 10. Do you have one or more last minute schedule changes in the Doctor s schedule per day? 11. Do you double book your patients in case they don t show? 12. Do you have new patients who cancel or no show as a rule? 13. Do you leave messages on patient s answering machines to confirm their appointment? w add up how many times you checked 4 Or under Great Job!!! 5-8 Work to be done It s time to get busy NOW implementing the systems in this report! CrownCouncil.info ~

17 Checklists: What is Your Prevention Score? 1. Do you always quote the fee and have a clear financial arrangement made? 2. Do you ask for commitment from the patient and deal with patient objections before scheduling the patient? 3. Do you maximize the patient s condition when presenting treatment? 4. Do you always do a great Relationship Link, being sure to include the patient in the conversation? 5. Do you state the benefit/concern to the patient when scheduling their next re-care visit? 6. When placing a confirmation call do you either speak directly to the patient or leave a message asking them to contact you regarding their appointment? 7. Do you have a clear cancellation protocol that both the patients and the team are aware of and do you follow that protocol? 8. Do you track all last minute cancellations and no shows either in the computer or in the patient s chart? 9. Do you call the late patient within the first 10 minutes of their appointment and do you show concern that they have not yet come in? 10. Have you or any of your team members had a conversation with a chronic canceller asking them for their commitment? 11. Do you show concern if a patient comes in late and do you ask them to wait while you see if you can accommodate them? 12. Do you always pull the patient s chart before rescheduling an appointment so that you can discuss the treatment? 13. Have you released patients from your practice because of 3 or more same day cancellations or no shows? 14. Do you ask the patient, What time of day could we schedule you so that you would be least likely to have any conflict? 15. When confirming an appointment, do you use words like Dr. Great looks forward to seeing you on Tuesday at 3:00 PM. Will you be here? w add up how many times you checked TotalPatientService.com ~ ToPS 4 Or under Good Job!!! 5-8 Work to be done It is time for an overhaul! 17

18 Additional Resources for Controlling Your Schedule: Stop the Insanity - Controlling the Schedule Before it Controls You! Webinar available for download at Stop Cancellations - Reduce cancellations, no shows and appointment changes. Webinar available for download at Total Immersion - Incorporating a Team Motivation strategy into your practice. Total Practice Support - Implementing the Strategy, a customized approach. Learn how a ToPS Practice Advisor can take your practice to the next level. Morning Opportunity Meeting Action Thoughts - Subscribe HERE Daily wisdoms and action ideas to start your morning heading in a productive direction. CrownCouncil.info ~

19 The Total Patient Service Institute aligns your practice with the ideas, techniques and systems based on The Natural Laws of To-tal Patient Service, practice achievement, and personal success. From its: Detailed practice analysis, Action-packed seminars, Interactive workshops, Idea-filled roundtables, and Performance driven Total Practice Support program lead by ToPS Practice Advisors, the ToPS Institute delivers exactly what its name says results that will make your practice ToPS! TOPS TotalPatientService.com The Crown Council is an international association of practices dedicated to creating A Culture of Success through continual improvement of the professional, the practice, and the community. The Crown Council provides exclusive resources for the ongoing effort in your practice to create a Culture of Success every day, with every team member and every patient , Success@CrownCouncil.com CrownCouncil.info TotalPatientService.com ~ ToPS 19

20 Often referred to as dentistry s Man, Steve Anderson has worked with thousands of dental teams, over the last 3 decades, to implement proven systems to increase case acceptance results. Presenter He has spoken at every major dental industry convention and meeting in the Englishspeaking world, conducted hundreds of seminars, and worked with thousands of businesses and organizations to increase their productivity and profits. His unique combination of proven systems, high energy, humor, and every day application, makes him one of the highest rated speakers at every venue where he appears. Steven J. Anderson Answers@TotalPatientService.com Total Patient Service ToPS topsinstitute Total Patient Service Author He has written hundreds of articles for industry publications and produced entire audio and video learning libraries. He currently hosts monthly programs viewed by thousands around the world, and has authored books, including The 13 Biggest Mistakes Parents Make and How to Avoid Them ( and The Culture of Success 10 Natural Laws for Creating the Place Where Everyone Wants to Work (www. TheCultureOfSuccessBook.com). Entrepreneur As the founder of over a dozen businesses, he has propelled organizations and individuals to the highest levels of performance and productivity. He is the founder of the Total Patient Service Institute, and the co-founder of the Crown Council, Dental Warranty Corp., and Capstone Dental. Before starting the Total Patient Service Institute, he was a business partner with the late Walter Hailey and the Dental Boot Kamp. He has been named Dental Businessman of the Year by Excellence in Dentistry. Philanthropist Doing good is part of the Culture of Success philosophy, and is a large part of all his organizations. As such, he is a co-founder of the Smiles for Life Foundation ( which has become the largest charitable campaign in dentistry, having raised and donated over $40 million to children s charities around the world. He is the founder of Eagle U ( a non-profit educational experience for high school and college-aged students, helping them get a 7-year head start on their career. EAGLE Youth Success