Best Practices for Appointment Reminders:

Reduce These Devastating Scheduling Glitches!

Has a patient ever visited your office for an emergency, been re-appointed for the next phase of treatment, but failed to appear for the next appointment? Usually this happens when the importance of necessary treatment has not been communicated well.  Prevention and strong communication skills are the key to reducing these scheduling glitches.

The reduction of broken appointments and no-shows starts in the clinical area by the clinical team. "Linkage communication" – or coordinated communication – between the clinical team and the business team is imperative for scheduling success and for moving a patient from the initial to the final appointment.

1. Give them a reason to come back. 

 At the end of every appointment, the clinical team member who is with the patient (whether it is the clinical assistant or the hygienist) should set the patient in an upright position and stress the significance of the next appointment. You want to plant in the patient's mind the benefits of the next appointment and the possible risks of not appointing or of not showing up for that appointment.

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2. Schedule with strong verbal skills.  

The appointment coordinator must stress not only the importance of that next appointment, but she must also indicate the amount of time being blocked for them in the doctor's schedule.  The appointment is the responsibility of the patient and you can help the patient accept that responsibility by the way you schedule in the first place.

3. Confirm appointments.

 Begin confirming appointments in the morning around 9 a.m. Confirm in a very positive manner, and always stress the importance of the appointment and the patient's responsibility for the appointment.

When you are originally scheduling the appointment, try to make notes in the patient's personal record regarding a particular area of concern. Then, when you are confirming, you can reinforce the need for the appointment relative to this area of concern. The patient will be more strongly motivated to come to the appointment if you stress the benefits of the appointment and certain risks that might occur if they do not come. In addition, you will be showing your patients that you go the extra mile in providing patient care. In other words, you aren't just calling off of a list; you are knowledgeable about their particular situation.

A message left is not a confirmation! If you have called at 9 and leave a message, then again at noon, and you are beginning to panic over the patient you cannot reach, then leave a message. However, in your message, ask the patient to call you to confirm his/her appointment.  Ask them to call by a certain time. Thank them for their cooperation.

If you are having a great deal of trouble with no-shows and broken appointments, you may want to start confirming your appointments two days in advance.  This will give you a little extra time should you have unavoidable changes of schedule. Pre-plan.  Engage in preventive management!

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4. Manage your recordings. 

If you are having a lot of changes of schedule left on your recording device during the night, you may want to consider changing your message to state that requests for changes in the schedule are not to be left on the machine but the patient can call back during office hours. You will maintain much better control with this recording:

5. Reschedule carefully.

If a person does call to make a change of schedule, obviously, your goal is to reschedule them while you have them on the phone. If you say, "Oh, that's OK. Call us when you think you can make it", or if you allow a person to just call at their convenience, then you have just committed appointment suicide.

Rather, when a person calls to tell you that they can't make an appointment that you carefully scheduled, say to the patient:

"Oh, Mrs. Jones, that is very difficult.  As you remember, we have scheduled two hours of your time and two hours of Dr. Jameson's time for this appointment.  At this late notice, I would not be able to fill the void left by your absence. This, of course, would be very difficult for us. I'm sure you can understand the dilemma.  Is there anything we can do to make it possible for you to come on for this appointment?"

If the person is ill or has some other unsolvable problem, obviously, you would accept that situation. Your responsibility is then to reschedule the appointment. If, for any reason you are unable to get that appointment rescheduled, ask the patient for permission to call them back.

Note the importance of giving two choices, either of which you are happy to accept. This is called an alternative of choice. Most people will respond positively to this request, to call them one time or the other. Make sure that you make a note of when you are to call.  Then, do it!  Always do what you have told a person you will do.  Use a tickler system, either a manual system or a computerized system.  Use it, and follow it.

6. No-shows.

 This is the most challenging of all scheduling glitches, and it is the one that is most difficult, if not impossible, to rectify.

  • Call the patient if he/she is 5 minutes late. 
  • Put the patient data in the tickler file if you are unable to reach them.  Don't let them slip away. Do not rely on information placed on the Saturday page of your schedule. After a while, you will stop looking back far enough, and patients will fall through the cracks.
  • Continue to try and contact the patient to find out why he/she didn't show.  Encourage him/her to reschedule. Let them know you care about him/her. 
  • If you are unable to contact the patient, send them a letter expressing your concern over the missed appointment. Stress your commitment to their health and well being. Let them know that you have tried on multiple occasions to call and reschedule the appointment. Invite them to call you for that rescheduling.



Author: Cathy Jameson
Published: 03/16/2010
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