How to Reduce/End Missed Appointments ONCE and FOR ALL!

NSDR_horizWant to Reduce/End Missed Dental Appointments In Your Practice? Great! Keep reading!

Charging a missed appointment fee after the fact is a punishment that does nothing to promote your practice or create what you really want-for patients to keep their appointments. Whether it is on your appointment cards or they are told verbally, it is of little concern to your patients. That message gets lost in their busy lives.

To get patients to keep their appointments, consider taking a comprehensive proactive strategy that works on the front end not the back end. The strategies need to encompass the three appointment types that matter: New patients, treatment patients and recalls. Each requires a slightly different strategy.

New Patients: By using my New Patient Reservation System you will set the scene for future visits in your practice, and patients will learn that your practice takes appointment times seriously. With this system, new patients are appointed with you after you obtain a credit card reservation. NO MONEY IS COLLECTED, I repeat NO MONEY is collected! The credit card info is simply on file to reserve the appointment time. When you do this system with your new patients they learn a very valuable lesson about your office-that you are SERIOUS about them coming in. Those patients REMEMBER that credit card reservation and don’t blow you off in the future either. Dentistry is a service based industry. Many other service based industries collect a credit card reservation. (When’s the last time you booked a vacation without one?) Worried that you will offend people over the phone? Don’t be. That’s what my system is all about. It teaches you how to do this so you DON’T offend people! The result will be that you will see people who WILL come to their appointments and who WILL understand that your time is valuable. Isn’t that what you’ve always wanted?

Treatment patients: Let’s say a hygiene patient comes in and you decide that he needs a crown. Immediately after seeing him for hygiene, you have a financial consult with him. The verbage in that consult encourages him to pay in full or make a deposit to hold his future crown reservation time. People who have a financial stake in the appointment will show. A lot of patients choose to pay in full right then and there. Some patients need more time to think about which option they would like and end up choosing to pay a deposit that day to hold until the day of treatment. Unlike others,  I recommend that you NOT have a “set” amount for the deposit. For example, if you tell the patient he must put down 50 dollars (or 50% or whatever)  to hold their spot, it becomes a barrier if they don’t have 50 dollars that day. For the patients making a deposit, let them put down WHATEVER they want!

Hygiene (Recall) patients: This is the most difficult category. I do NOT recommend collecting a deposit for this. (Although enrolling your patients in the Quality Dental Plan is sort of like them pre-paying for hygiene. Patients who pay in advance WILL show up!)
I do recommend pre appointing your patients. Remember- earlier I mentioned that patients who go through the reservation system will take your office more seriously. We all know how hard it is to rely on those new patients to show up for their first 6 month check up. It was FASCINATING to me to see that population of patients (the ones who had gone through the reservation system) consistently return 6 months later. Back in the day, those new patients would “forget” about even making the next appointment. Sometimes they would even “forget” who we were. That doesn’t happen anymore.  What I have found is those patients who have gone through my reservation system keep subsequent appointments more seriously. That being said the reminders are what the real key is. We remind our recall patients with a postcard two weeks prior. We also send out an email 1 week prior. The emails come straight from our office-not an automated service. In the email, we ask that the patients reply back if they will be keeping their reservation. They write us back and let us know. Those who don’t reply (or patients we don’t have email addresses for) get phone calls the day before. We aren’t satisfied with just leaving messages. We call every number we have for the patient until we reach them and actually speak with them to confirm. We also have incorporated the words, ‘reserve’ and ‘reservation’ into our vocabulary around here.

We started doing all of this a few years ago and watched our missed appointments dramatically decrease overtime. It didn’t happen overnight. We had to retrain a lot of our long time patients. It was hard work, but the consistency paid off. We currently have at least a  97% attendance rate across the board for our practice per month. That has greatly boosted our bottom line!!!!

In general, of course, it also helps to offer a great service to our patients and they will WANT to come in as well. Don’t keep people waiting in the waiting room. Know their names when they walk into the office. Know the names of their kids. Have some beverages ready for them. Keep the office looking and smelling nice. Have great employees who know how to express value and who know how to support and praise the doctor. Do good dentistry. Keep fees reasonable.

Everything we do should satisfy the following three things:
Be Proactive. What can you do now that will make things easier later? (Sending out a missed appointment fee is NOT being proactive!)
Be Systematic. Each system should be written down, should track accountability, and should measure progress.
Be Consistent. Don’t let things fall by the wayside. Stick with protocol and procedure.

What are the biggest broken appointment problems in your office? New Patients? Treatment Patients? Hygiene Patients?

About Missy


  1. So far for the month of April, we are at 98% attendance!

  2. Congrats! You have a great website. I am starting to dig your dental resources.

  3. This are very useful tips! I especially love the part about asking for deposits without setting a predetermined amount. That way our patients will feel that they are not forced into an agreement right away and have more freedom to choose an amount better suited for their budget. I will definitely be implementing that! Great article!

  4. Thanks! I appreciate the kind words.
    I decided a long time ago that the amount of the deposit doesn’t really matter…it’s just the fact that they’ve put SOMETHING down that will equate to them returning for their next visit!

  5. We initiated requiring a credit card on file to reserve an appointment and it really has helped our new patients to take seriously the importance of showing up for their appointment. From time to time a potential new patient will resist this idea, but it has been far fewer than we expected.

  6. You ROCK Missy! Our clients who use your new patient reservation system LOVE LOVE LOVE it! 🙂 noticeable increase in production and KEPT appointments! 🙂

  7. Missy,
    Fascinating article. Two questions, please: If a prospective new patient will not give a credit card # to make the appointment, do you not make the appointment? Also, when discussing future treatment in the “financial consult,” and the patient gives a down payment (deposit) to hold their reservation, if they fail to keep their appointment, what happens to their deposit? They lose it? Help until next time?
    Dr. Duane Taylor

  8. Hello there!
    Both of these questions are answered in both systems, but here are the short answers.

    If a prospective new patient does not give a credit card #, then the reservation cannot be made, BUT they can still be seen only with a same day appointment.

    You will find that once a patient gives a down payment, they don’t often forget their next appointment! That’s why it’s so great to get!

    Sorry for the delay, this message never made it to me until now!
    Take care!

  9. I think no one intentionally want to skip their dental appointment. Because without any need no one schedules an appointment for their dental problem. If they skip the appointment, there might be any strong reason to do so. As we are a business and we need customers to survive. There are many ways through which you can avoid skipping the appointments. I have an idea that just tell the patient that if he/she skips the appointment, he/she will not be eligible to book another appointment for with you for at least three months.

  10. When making a new patient appointment and asking for a credit card to reserve the appointment, do you let them know if they no show or don’t reschedule before a 24 hour time frame they will be charged $X? If not, what is the point of having a credit card on file, the patient can just not show up without any consequences. Not that we actually charge that, but that they know what happens if they no show, so that they are more inclined to actually come.

  11. We do let them know that there will be a charge, but we never have to charge it because patients show up. They are WAY more inclined to show up if they think there will be a charge. On the rare times that they know there will be a charge and they still no show, I never actually charge them. It’s not about the money. It’s about knowing who will waste your time. We just make a note to not allow that patient to schedule in our practice again.