September 15, 2025 • 22 mins
We all have those patients that call and say they’re “sick” at the last minute. When it keeps happening, you’ve got to ask: is your cancellation policy working, or just being ignored?
In this episode, the DPH coaches share how they reduce no-shows and last-minute cancellations, hold patients accountable, and get their team to follow through. From how much to charge (if anything) to getting patients to value your time, you’ll learn how to lower your cancellation rate without losing patients.
Topics discussed in this episode:
- What your average cancellation rate should be
- Henry’s $50 deposit policy
- Why patients no-show or cancel last minute
- Language that reduces cancellations
- Training your team to enforce policies
- How to balance being understanding and staying firm
This episode was produced by Podcast Boutique https://www.podcastboutique.com
GRAB THE FREE PLAYBOOK HERE - Discover 30 proven strategies top-performing dentists use to increase profits, cut clinical days, and finally enjoy the freedom they originally built their practices for.
https://www.dentalpracticeheroes.com/playbook
Take Control of Your Practice and Your Life
We help dentists take more time off while making more money through systematization, team empowerment, and creating leadership teams.
Ready to build a practice that works for you? Visit www.DentalPracticeHeroes.com to learn more.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:02):
Are you tired of empty chairs and last minute
cancellations?
They're not just annoying, theycost us money and waste
everybody's time.
Today, we're not just debatingwhether we should charge
patients or not or how much, butwe're also talking about how
you can keep no-shows fromhappening in the first place.
You're going to hear thepolicies that work in our
(00:22):
practice, how we get our team tofollow them and how we get our
patients to respect them.
If your cancellation rate ishigh, this is an episode you
will not want to miss.
Let's do it.
You are listening to the DentalPractice Heroes podcast, where
we teach dentists how to stepback from the chair, empower
their team and build a practicethat gives them their life back.
(00:43):
I'm your host, dr Paul Etcheson, dental coach, author of two
books on dental practicemanagement and owner of a large
four-doctor practice that runswith ease while I work just one
clinical day a week.
If you're ready for a practicethat supports your life instead
of consuming it, you're in theright place.
My team of legendary dentalcoaches and I are here to guide
you on your path fromoverwhelmed owner to dental
(01:06):
practice hero.
Let's get started.
Welcome back to the DentalPractice Heroes podcast, the
most popular and most listenedto dental podcast in all of the
universe.
You are here sharing it with usand we're so thankful that
you're here.
We are here with a DPH coach, drHenry Ernst, owner of an 18-op
(01:26):
practice in Carolina, justpracticing two days a week, and
Dr Steve Markowitz he's got sixpractices on the East Coast
practicing still one day a weekand myself also a one-day-a-week
dentist.
We're here to help you figureout how to run a team-driven
practice so you can chill more,take more time off and make more
money.
So today we're talking about abig part of inefficiency at the
(01:48):
dental office and, my God, Ihave worked with a lot of
clients and it gets horrible.
It is your cancellation and noshow rate and, man, I have seen
ones as high as 30%, which isbonkers.
And if I had to say what isaverage man, I'd say probably
about 18, 20%.
But you know we'll get into itand we'll figure out what we
(02:10):
think is going on.
So I'm going to pass it to you,henry, what has your experience
been with cancellation policyand is this something that you
even focus on?
Speaker 2 (02:17):
Very important.
I think the most importantthing is having a policy and
sticking to it, not beingwishy-washy.
That's probably the main thingI see with clients and dental
practices.
They put a policy in place.
I mean, I'll tell you ours.
Ours is $50 deposit.
We're open on Saturday, soevery single patient that comes
hygiene or doctor $50 deposit.
(02:37):
That deposit will go towardsyour treatment or will get
refunded to you on the day thatyou make your appointment, that
you actually show up Doctorappointments every single day.
Anything over $1,500, $50deposit, it's not much, it's not
about the money at all, but wehave to hold them accountable.
If you no-show cancel for anyreason, within 48 hours you
(02:59):
forfeit it.
Speaker 1 (02:59):
What if someone's sick, you forfeit it?
I just want to play devil'sadvocate because, like this is
what you're going to get fromyour team.
Is you're going to say peopleare going to say, well, it's so
hard to tell somebody.
If they call me and they say Iam so sick, do you really want
me to come in?
Cause I'll come in, but I got,I'm throwing up and you know,
you know people lie, but I meanstill $50.
Speaker 2 (03:18):
So we stuck with it place for about seven years now
and we've just stuck with it.
People are going to come upwith excuses, people are going
to say this or that and the lineit's not what we like to say.
It's not epitome of customerservice.
But the office policy is 48hours notice.
Right, be more proactive withyour notice.
As soon as you don't give ustime, you know we can't do
(03:41):
anything.
We can't take back time.
I, we can't do anything, wecan't take back time.
I'll also say this on the frontend when your team members are
scheduling people.
This is the typical dentaloffice.
Hey, paul, let's get you on theschedule to do that root canal.
Okay, sounds great.
Number one you're putting theappointment, associating it with
a root canal procedure, whichalready may give somebody a
chance not to show up.
(04:01):
Yeah, I don't think I'm coming.
The alternate version is hey,paul, let's set aside some time
with the doctor so he can fixthat tooth that he was talking
about right Now.
It's not associating root canalwith the visit and it's also
putting the emphasis on securingthe time with the doctor.
Patients don't care about ourtime, they don't appreciate our
(04:22):
time, they don't know how muchit costs to run a practice per
hour.
We have to make sure that theemphasis is there on we're
reserving this time for you andI think don't be wishy-washy
with it.
Just really, it kind of hit mewhen we first put this in place
years ago and we had a patientright in the beginning when we
started it wishy-washy rightPatient.
When we started it, wishy-washyright Patients called up the
(04:43):
office and said oh, I'm supposedto come in for a couple of
crowns at six o'clock.
I don't know if I'm going tomake it.
What's going to happen if Idon't show up?
And team member comes back toask me that and I said well,
they're going to forfeit thedeposit.
And what happened?
The guy showed up and when thathappened I jumped up and down.
I said see, this stuff works.
He's a nice guy.
(05:03):
I actually asked him.
I said if it wasn't for the $50, would you have not shown up?
He's like yeah, I wasn'tfeeling like coming.
And I'll tell you what happensa lot, especially with our
Saturday patients.
Patient shows up on Saturday,gets their hygiene visit done
and they set aside their nextone.
Hey, just leave my deposit on.
So most people, especially ourSaturday frequent flyers, we
call them they just have the $50deposit, it's in their chart
(05:25):
and they just leave it in theirimpotuity.
Speaker 1 (05:28):
Everybody.
What about new patients?
No, we don't do new patients?
Yeah, Okay cool.
Speaker 2 (05:37):
But I think the main point I'm just trying to make is
come up with a policy that yourteam can be on board with,
because they have to standbehind it.
They're the ones who have todefend it and say the, and
behind it, they're the ones whohave to, you know, defend it and
say the, and then you, as theowner, don't wiggle, stay
consistent the moment you wiggleon one.
Speaker 1 (05:53):
they're going to ask you again and again and again
how about you, steve?
How's this looking in youroffice Like?
What's your experience been?
Speaker 3 (05:56):
Yeah, I love all what Henry just said.
There is nothing if I couldhighlight on a podcast highlight
.
There is nothing more expensivethan empty chair time nothing.
So it costs the office, thepractice, more than anything you
are doing.
So people spend so much timelooking at their supplies and
their marketing and all thisline items they should spend
(06:17):
just as much time on, or, if notmore, they should spend more
time on, making sure, when theoffice is open, the chairs are
full.
So there are two things of whypeople don't show up to
appointments.
One is they don't value theservice that you're providing
enough more so than whateverelse they want to do, and that
could be because of fear.
Number two, they don't have arelationship strong enough with
(06:39):
either you or the person they'reseeing and they don't respect
their time.
So what we do, we spend a lotof time on both of those two
things, meaning I want ourhygienists and our assistants
and our doctors to know theirpatients and be able to look at
the schedule and be like there'sa chance that person doesn't
(07:00):
show up.
What I would hate more thananything when I first started
doing this is I would look atthis schedule and I would be
able to pick out who wouldn'tshow up and then they wouldn't
show up.
Whose fault is that?
So the policy needs to alignwith rewarding the people who
are great patients and you knoware going to show up and getting
rid or punishing the patientswho aren't going to be part of
(07:22):
this anyways.
So what we do is we highlightpatients who we know are high
risk.
They either have to call tomake an appointment or, if they
are on there and they're highrisk, they need to call back and
we need to physically talk tothem and say they're going to
show up and if they don't callus back, we fill that
appointment and then we do notever, ever, ever allow someone
(07:44):
to reschedule their appointmentto tomorrow or within the next
week, like there has to be somekind of consequence for not
respecting our time.
So if someone's going to callus and they're going to move,
even if there's open share time,we are going to either move it
out or say call us when it's aconvenient time and we'll see if
we can get you in that day.
(08:05):
I don't believe fully incharging people for missed
appointments.
I don't want to fight makethose.
I don't want to have thosefights.
I'm not in the business ofcollecting 50 or $75 for missed
appointment times.
It's not worth my time.
It's written in our policiesbut we write that off.
Whether that's wrong or right,I'm happy to fight that out.
Speaker 1 (08:24):
Well, I think that's critical to point out, because
we had this conversation with myteam.
I'm always big about as theleader.
We've got to create a way thatthere has to be a why.
You have to really identifywhat is the goal of the policy
or the procedure.
When I say what is the goal ofthe $50 charge, some people
(08:48):
would say, well, to cover thehygienist time.
And I'm like, no, the goal iswe just want them to show up for
their damn appointment.
I could care less about $50.
I mean $50 for the chance ofgetting a negative review for
charging 50.
So when we had a really highcancellations, we got up to like
15, 16% at one point.
What we started doing is westarted telling people we had to
make sure they talked about it.
That was the part that wasmissing.
Nobody was talking about it.
It was like you want to canceltoday?
(09:08):
Okay, sure, let's reschedule.
You know, nothing happened, butso.
But what we found is that if wetalk about it, we make a big
deal about it and then we say,hey, I'm supposed to charge you
$75.
I'm going to waive it this time, but in the future I need you
to know that I can only do itonce and what would happen is it
would start to kind of weed outthe bad people, because then
(09:30):
those people we would require adeposit and then they would
either not pay it and gosomewhere else or they would
start showing up for theirappointments.
But the effectiveness in thatpolicy was in the discussion and
the consistency of thediscussion.
It wasn't so much in the actualcharge.
But then when you're talkingabout how to read these deposits
for everybody, there's part ofme thinking that my policy it
(09:52):
didn't work until we warned thepatient and they got away with
it once, Whereas in your policyit is a focal part of the
discussion for almost everysingle appointment.
So it's almost like apreemptive, more proactive
approach and that's what I thinkI like about it.
Speaker 2 (10:08):
Yeah, well, I think in the semantics here is
important too.
It's not a charge, it's adeposit.
Right, when I think charge, I'mthinking my money's gone, I'm
not getting it back.
A deposit is just hey, we'reasking to leave this, you know,
as collateral for our time.
And this is the other thingthat comes up in dentistry Okay,
I need to come to your officeand I'm going to get two crowns
(10:29):
done $3,000, let's say, toschedule.
Am I required to leave all themoney before I make that
appointment or am I required todo a deposit?
Right, we kind of went back andforth with that discussion and
what worked for our office wasthe deposit.
Right, try to get the money.
Hey, listen, this is whatyou're due next time.
Would you like to pay it now asa convenience?
Okay, well, at minimum I needthe deposit for the doctor's
(10:51):
time and blah, blah, blah, theygive the policy there While it's
on my mind.
One other thing that reallyjust aggravates the crap out of
me, and I hear medicalpractitioners when they call you
know to hey, you've got anappointment with our office on
Friday.
If you need to cancel beforethe first thing they say if you
need to cancel, like, don't eventell me that, Don't even give
me that option.
It's not an option.
Don't say it, don't even offerit, because the moment you say
(11:13):
that and it's nice outside inthe Carolinas there's a decent
chance they're going outside.
Speaker 1 (11:17):
I think it should be.
If you need to cancel, don't.
Speaker 3 (11:21):
That's like one of the seven naughty words.
We don't use that word.
So, like what we train our teamto do is, when they're calling
patients to say, like we don'teven say we have a cancellation
list.
We were able to move somethings around and now have an
opening for this time.
Does this time work for you?
I don't want that word comingout of anyone's mouth.
Speaker 1 (11:45):
It's just part of our bread.
What's something that I thinkis crucial to go through is what
is acceptable and what'sunacceptable.
You know one discussion I hadwith my team.
We said 24 hours.
A lot of people are 48.
What are you guys?
Just really quick 48.
48.
Okay, so we're 24.
We did 24 just to make itreally easy and we just never
changed it.
And I'm curious like we want totreat everybody the same and we
want to say that to our patients.
Hey, we don't want to have tomake decisions, we want the only
(12:08):
way to be fair with everybodyis just have it be black and
white.
But what do you say to someonewho says someone was had to get
rushed to the hospital, afuneral, someone passed away,
Like I mean, is it so cut anddry that there's no exception
for bending?
Because what I struggle withwith my team is that if we allow
them to bend a little bit, it'sjust like they just blow it
open.
They take it to the next level.
(12:29):
That's just like now.
It's like damn it, that's notwhat I wanted.
What do you guys think of that?
Speaker 3 (12:33):
So for us, one of our values is it's never the wrong
thing to do the right thing.
So we can apply this to ourcancellation policy and if
someone calls and says I need totake my mom to the hospital or
I'm not feeling good or whatever, and I could go up to that team
member and say why is henry nothere today?
And they're like, oh they, theyhad to do.
(12:53):
Did you push back?
No, it was the right thing todo.
He really seemed like he was ina panic.
End of discussion, that's ityeah and that's again.
I understand the black andwhiteness and team members love
having that black and whitepolicy, but people are not black
and white and if we start totreat them like that, then I
feel in my world at least, Ifeel like that we start treating
(13:18):
patients more like numbers asopposed to understanding what
they're going through and wherethey're at.
So the black and whiteness ofwhat I'm trying to create is I
have enough trust in the personon the phone and if they think
that's the right thing to do,that's the right thing to do.
With that being said, we can'thave repeat offenders.
So, yes, it's okay if someonecalls out sick once every two or
(13:42):
three years maybe, but within18 months if we've had to move
their appointment more than twotimes, we're too busy for that.
That's not fair.
The policy that we have is yes,we have leniency, but we can't
have the expectation that thisperson's not going to show and
we need to track how many timesthey're either moving their
appointment or no showing.
Speaker 1 (14:02):
What if someone sounds really sick man I just I
can't come in.
Oh, can't make it, Don't comein.
Is that a violation?
Yes, that's a charge.
Speaker 3 (14:12):
It's not a violation.
I'm so sorry you're sick.
I do want you to know.
We're booking out like 10months and we probably won't be
able to get you in.
Do you want me to put you onASIP list?
Are you sure there's any wayyou can come into this
appointment?
How do you want me to best helpyou and then help navigate the
conversation?
I don't think it's ever helpfulfor us to be like.
This is our cancellation policy.
(14:34):
Yes, I understand it, but thepatient on the other side
doesn't want to hear that.
They just want to be helped.
Speaker 1 (14:44):
It's just so hard.
Because I struggle with thisand I think a lot of practice
owners can relate to it is Iwant my team to use their brains
and I want them to do the rightthing, and I will never shame
them for allowing somebody someleniency and making exceptions.
But it drives me crazy whenthose exceptions become so
consistent that it's like youjust didn't want to have a
difficult conversation.
Speaker 3 (15:03):
But that's the training when we found most,
besides having those high-riskpatients need to actually call
back the office, the little bitof pushback and says just say,
if someone calls and says I'm sosick, I'm so sorry, I hope
you're okay, you sure there'sany way you can make it today.
I'm booking out so far.
And if they still say like no,no, no, okay, all right, do you
want me to give you a call backor do you want to try to
(15:24):
schedule that now Because,honestly, we can't see it till
February Again, I think some ofthat that starts with training
our team and then us as doctors,backing them up with the
decision that they made and notNot poopooing it.
Speaker 2 (15:38):
You know, this is a great conversation, and I think
we could have this with 10, 20doctors, and we're all going to
have different perspectives,right?
This is the beauty of being abusiness owner there's nobody
who's right, nobody has theright answer and nobody has the
wrong answer.
It's all about what reallyworks and what do you feel
strongly about.
You know we have our policy,that it's a little bit black and
white, I'll be honest with you,and I work two days a week, so
(16:07):
if there's ever an exceptionthat needs to be made, they're
going to reach out to me.
You know they're going to textme and they're going to ask me
whatever, and knock on wood, Ihaven't got any question like
that.
I can't remember.
So it must be working.
Speaker 1 (16:14):
Yeah, right, see, I hate that.
I hate when you let me ask theowner and I tell my team do not
do that to me, because then youjust immediately make me look
like an a-hole if I say no.
Speaker 2 (16:24):
Well, I've empowered them to make good decisions and
do the right thing.
But the policy is pretty blackand white Gosh.
Maybe like a year ago there waslike somebody who I really knew
patient's been in the practicefor a long time and I kind of
did what you said, steve.
I said you know what?
Let's give them some grace Gosh, what let's give them some
grace Gosh.
They've been a practice so long, so there's never going to be a
right answer here.
But I think what has worked forme was to make the policy that
(16:46):
the team agrees with, the teamis on board with, and we'll
stand behind and stand behind it.
Don't wiggle one way or theother, or else you're going to
get everybody that takesadvantage of it.
Speaker 1 (16:56):
Yeah, I'm just curious for your situation.
You're asking for a deposit,which I think a lot of people
would love to do for hygiene.
Our solution we have rarelyhave a failure reschedule.
On the doctor side, we'retrying to collect the whole
patient copay.
We take half that as ourrequirement but we try to
collect all of it because weknow when we collect all of it,
when that person comes in thatday it's going to be a better
(17:16):
experience.
They won't ask questions abouttheir insurance coverage, they
won't have any financialquestions.
We get all that out of the wayand we'll tell the patient.
We like to get the financialstuff out of the way so that we
can stay on time the day of theappointment.
So all of our we're an on-timeoffice.
But I'm curious how your teamis presenting this deposit.
Like there's got to be someverbal training and there's got
to be a way to do it.
(17:36):
And I'm just I'm curious whatthey say.
Speaker 2 (17:42):
So with hygiene it's almost like a joke, right?
You make it like a fun thing,right?
We only do it for hygiene onSaturday hygiene appointments.
So not every day, not every day, just Saturday.
Because what we noticed was allof a sudden it's a nice day
outside and stuff like that, andall of a sudden your Saturday
hygiene, which had three or fourcolumns, all of a sudden like
half of it's gone.
So we did it just for thatpurpose and we joke around with
(18:02):
the patients like listen, it'skind of like sitting in first
class.
No other offices are open onSaturday.
You're getting to come in andget your teeth cleaned.
All that we're asking is a $50deposit to reserve that time in
first class for you, and they'reall fine with it.
And, like I said, I think it'sto the point now where people
have their deposits on file andthey just leave them for the
next one, for the next one.
Speaker 1 (18:23):
Yeah, I think I want to do this at my office and I
want to do it for appointmentsafter four o'clock because it's
such a high priority time.
And I mean we've got peoplescheduling three, four
appointments ahead of time, Likethey're scheduling their next
two years of appointments, andit's like I don't mind doing
that, but at the same time it'slike I don't know it's such a
give and take of trying to beaccommodating and not getting
(18:45):
abused at the same time.
Speaker 2 (18:47):
It seems that analogy works well with the patients.
You mentioned it, steve too.
We're.
Hey, we're really popular,we're.
Our Saturday appointments arebooked out for eight, 10 months,
you know.
So if you want to reserve thattime, I would highly suggest we
do it, and all we ask is a $50deposit, right?
Speaker 1 (19:02):
Yeah, and, like Henry said, there's no right or wrong
answer.
It's just you've got to havesomething, you've got to discuss
it as a team and you've got tostick to it.
Consistency it's so importantin everything we do, consistency
.
I'm going to let you do thefinal thoughts, steve.
What do you?
Speaker 3 (19:16):
think I think for any policy, especially the
cancellation policy, because Ithink we hammered home how
important it is the team needsto know exactly what it is.
You need to train how you wantthose situations to be handled
and then you need to followthrough on what you said you
were going to do and thepatients who want to be there
(19:37):
will be there and don't fight.
My recommendation would bedon't make fights over $75 or
$50.
Let those patients go fightwith someone else.
Speaker 2 (19:47):
Totally, henry.
Final thoughts yeah, love it.
Don't want those patients inyour office when you've got a
growing, successful, happypractice.
We don't need those people thatare just the vampires of our
time.
Have the policy in place, stickwith it and don't be afraid to
revisit it.
You know, we revisited beforeand now we found something that
(20:08):
really works and we'reconsistent with it.
Speaker 1 (20:09):
It's a great point, awesome.
Well, if you are listening andyou're thinking, this is the
year you're going to get yourpractice to run without you and
have it be smooth, flowing,systematized this is the kind of
stuff we do at Dental PracticeHeroes.
Go check out our website,dentalpracticeheroescom and see
what coaching packages we have.
We want to help you live abetter life and be better in
every regard because of yourpractice, so that's what we're
(20:30):
here for.
Go check us out.
Thank you so much for listening.
We'll talk to you next time.
Are you tired of empty chairs and last minute
cancellations?
They're not just annoying, theycost us money and waste
everybody's time.
Today, we're not just debatingwhether we should charge
patients or not or how much, butwe're also talking about how
you can keep no-shows fromhappening in the first place.
You're going to hear thepolicies that work in our
(00:22):
practice, how we get our team tofollow them and how we get our
patients to respect them.
If your cancellation rate ishigh, this is an episode you
will not want to miss.
Let's do it.
You are listening to the DentalPractice Heroes podcast, where
we teach dentists how to stepback from the chair, empower
their team and build a practicethat gives them their life back.
(00:43):
I'm your host, dr Paul Etcheson, dental coach, author of two
books on dental practicemanagement and owner of a large
four-doctor practice that runswith ease while I work just one
clinical day a week.
If you're ready for a practicethat supports your life instead
of consuming it, you're in theright place.
My team of legendary dentalcoaches and I are here to guide
you on your path fromoverwhelmed owner to dental
(01:06):
practice hero.
Let's get started.
Welcome back to the DentalPractice Heroes podcast, the
most popular and most listenedto dental podcast in all of the
universe.
You are here sharing it with usand we're so thankful that
you're here.
We are here with a DPH coach, drHenry Ernst, owner of an 18-op
(01:26):
practice in Carolina, justpracticing two days a week, and
Dr Steve Markowitz he's got sixpractices on the East Coast
practicing still one day a weekand myself also a one-day-a-week
dentist.
We're here to help you figureout how to run a team-driven
practice so you can chill more,take more time off and make more
money.
So today we're talking about abig part of inefficiency at the
(01:48):
dental office and, my God, Ihave worked with a lot of
clients and it gets horrible.
It is your cancellation and noshow rate and, man, I have seen
ones as high as 30%, which isbonkers.
And if I had to say what isaverage man, I'd say probably
about 18, 20%.
But you know we'll get into itand we'll figure out what we
(02:10):
think is going on.
So I'm going to pass it to you,henry, what has your experience
been with cancellation policyand is this something that you
even focus on?
Speaker 2 (02:17):
Very important.
I think the most importantthing is having a policy and
sticking to it, not beingwishy-washy.
That's probably the main thingI see with clients and dental
practices.
They put a policy in place.
I mean, I'll tell you ours.
Ours is $50 deposit.
We're open on Saturday, soevery single patient that comes
hygiene or doctor $50 deposit.
(02:37):
That deposit will go towardsyour treatment or will get
refunded to you on the day thatyou make your appointment, that
you actually show up Doctorappointments every single day.
Anything over $1,500, $50deposit, it's not much, it's not
about the money at all, but wehave to hold them accountable.
If you no-show cancel for anyreason, within 48 hours you
(02:59):
forfeit it.
Speaker 1 (02:59):
What if someone's sick, you forfeit it?
I just want to play devil'sadvocate because, like this is
what you're going to get fromyour team.
Is you're going to say peopleare going to say, well, it's so
hard to tell somebody.
If they call me and they say Iam so sick, do you really want
me to come in?
Cause I'll come in, but I got,I'm throwing up and you know,
you know people lie, but I meanstill $50.
Speaker 2 (03:18):
So we stuck with it place for about seven years now
and we've just stuck with it.
People are going to come upwith excuses, people are going
to say this or that and the lineit's not what we like to say.
It's not epitome of customerservice.
But the office policy is 48hours notice.
Right, be more proactive withyour notice.
As soon as you don't give ustime, you know we can't do
(03:41):
anything.
We can't take back time.
I, we can't do anything, wecan't take back time.
I'll also say this on the frontend when your team members are
scheduling people.
This is the typical dentaloffice.
Hey, paul, let's get you on theschedule to do that root canal.
Okay, sounds great.
Number one you're putting theappointment, associating it with
a root canal procedure, whichalready may give somebody a
chance not to show up.
(04:01):
Yeah, I don't think I'm coming.
The alternate version is hey,paul, let's set aside some time
with the doctor so he can fixthat tooth that he was talking
about right Now.
It's not associating root canalwith the visit and it's also
putting the emphasis on securingthe time with the doctor.
Patients don't care about ourtime, they don't appreciate our
(04:22):
time, they don't know how muchit costs to run a practice per
hour.
We have to make sure that theemphasis is there on we're
reserving this time for you andI think don't be wishy-washy
with it.
Just really, it kind of hit mewhen we first put this in place
years ago and we had a patientright in the beginning when we
started it wishy-washy rightPatient.
When we started it, wishy-washyright Patients called up the
(04:43):
office and said oh, I'm supposedto come in for a couple of
crowns at six o'clock.
I don't know if I'm going tomake it.
What's going to happen if Idon't show up?
And team member comes back toask me that and I said well,
they're going to forfeit thedeposit.
And what happened?
The guy showed up and when thathappened I jumped up and down.
I said see, this stuff works.
He's a nice guy.
(05:03):
I actually asked him.
I said if it wasn't for the $50, would you have not shown up?
He's like yeah, I wasn'tfeeling like coming.
And I'll tell you what happensa lot, especially with our
Saturday patients.
Patient shows up on Saturday,gets their hygiene visit done
and they set aside their nextone.
Hey, just leave my deposit on.
So most people, especially ourSaturday frequent flyers, we
call them they just have the $50deposit, it's in their chart
(05:25):
and they just leave it in theirimpotuity.
Speaker 1 (05:28):
Everybody.
What about new patients?
No, we don't do new patients?
Yeah, Okay cool.
Speaker 2 (05:37):
But I think the main point I'm just trying to make is
come up with a policy that yourteam can be on board with,
because they have to standbehind it.
They're the ones who have todefend it and say the, and
behind it, they're the ones whohave to, you know, defend it and
say the, and then you, as theowner, don't wiggle, stay
consistent the moment you wiggleon one.
Speaker 1 (05:53):
they're going to ask you again and again and again
how about you, steve?
How's this looking in youroffice Like?
What's your experience been?
Speaker 3 (05:56):
Yeah, I love all what Henry just said.
There is nothing if I couldhighlight on a podcast highlight
.
There is nothing more expensivethan empty chair time nothing.
So it costs the office, thepractice, more than anything you
are doing.
So people spend so much timelooking at their supplies and
their marketing and all thisline items they should spend
(06:17):
just as much time on, or, if notmore, they should spend more
time on, making sure, when theoffice is open, the chairs are
full.
So there are two things of whypeople don't show up to
appointments.
One is they don't value theservice that you're providing
enough more so than whateverelse they want to do, and that
could be because of fear.
Number two, they don't have arelationship strong enough with
(06:39):
either you or the person they'reseeing and they don't respect
their time.
So what we do, we spend a lotof time on both of those two
things, meaning I want ourhygienists and our assistants
and our doctors to know theirpatients and be able to look at
the schedule and be like there'sa chance that person doesn't
(07:00):
show up.
What I would hate more thananything when I first started
doing this is I would look atthis schedule and I would be
able to pick out who wouldn'tshow up and then they wouldn't
show up.
Whose fault is that?
So the policy needs to alignwith rewarding the people who
are great patients and you knoware going to show up and getting
rid or punishing the patientswho aren't going to be part of
(07:22):
this anyways.
So what we do is we highlightpatients who we know are high
risk.
They either have to call tomake an appointment or, if they
are on there and they're highrisk, they need to call back and
we need to physically talk tothem and say they're going to
show up and if they don't callus back, we fill that
appointment and then we do notever, ever, ever allow someone
(07:44):
to reschedule their appointmentto tomorrow or within the next
week, like there has to be somekind of consequence for not
respecting our time.
So if someone's going to callus and they're going to move,
even if there's open share time,we are going to either move it
out or say call us when it's aconvenient time and we'll see if
we can get you in that day.
(08:05):
I don't believe fully incharging people for missed
appointments.
I don't want to fight makethose.
I don't want to have thosefights.
I'm not in the business ofcollecting 50 or $75 for missed
appointment times.
It's not worth my time.
It's written in our policiesbut we write that off.
Whether that's wrong or right,I'm happy to fight that out.
Speaker 1 (08:24):
Well, I think that's critical to point out, because
we had this conversation with myteam.
I'm always big about as theleader.
We've got to create a way thatthere has to be a why.
You have to really identifywhat is the goal of the policy
or the procedure.
When I say what is the goal ofthe $50 charge, some people
(08:48):
would say, well, to cover thehygienist time.
And I'm like, no, the goal iswe just want them to show up for
their damn appointment.
I could care less about $50.
I mean $50 for the chance ofgetting a negative review for
charging 50.
So when we had a really highcancellations, we got up to like
15, 16% at one point.
What we started doing is westarted telling people we had to
make sure they talked about it.
That was the part that wasmissing.
Nobody was talking about it.
It was like you want to canceltoday?
(09:08):
Okay, sure, let's reschedule.
You know, nothing happened, butso.
But what we found is that if wetalk about it, we make a big
deal about it and then we say,hey, I'm supposed to charge you
$75.
I'm going to waive it this time, but in the future I need you
to know that I can only do itonce and what would happen is it
would start to kind of weed outthe bad people, because then
(09:30):
those people we would require adeposit and then they would
either not pay it and gosomewhere else or they would
start showing up for theirappointments.
But the effectiveness in thatpolicy was in the discussion and
the consistency of thediscussion.
It wasn't so much in the actualcharge.
But then when you're talkingabout how to read these deposits
for everybody, there's part ofme thinking that my policy it
(09:52):
didn't work until we warned thepatient and they got away with
it once, Whereas in your policyit is a focal part of the
discussion for almost everysingle appointment.
So it's almost like apreemptive, more proactive
approach and that's what I thinkI like about it.
Speaker 2 (10:08):
Yeah, well, I think in the semantics here is
important too.
It's not a charge, it's adeposit.
Right, when I think charge, I'mthinking my money's gone, I'm
not getting it back.
A deposit is just hey, we'reasking to leave this, you know,
as collateral for our time.
And this is the other thingthat comes up in dentistry Okay,
I need to come to your officeand I'm going to get two crowns
(10:29):
done $3,000, let's say, toschedule.
Am I required to leave all themoney before I make that
appointment or am I required todo a deposit?
Right, we kind of went back andforth with that discussion and
what worked for our office wasthe deposit.
Right, try to get the money.
Hey, listen, this is whatyou're due next time.
Would you like to pay it now asa convenience?
Okay, well, at minimum I needthe deposit for the doctor's
(10:51):
time and blah, blah, blah, theygive the policy there While it's
on my mind.
One other thing that reallyjust aggravates the crap out of
me, and I hear medicalpractitioners when they call you
know to hey, you've got anappointment with our office on
Friday.
If you need to cancel beforethe first thing they say if you
need to cancel, like, don't eventell me that, Don't even give
me that option.
It's not an option.
Don't say it, don't even offerit, because the moment you say
(11:13):
that and it's nice outside inthe Carolinas there's a decent
chance they're going outside.
Speaker 1 (11:17):
I think it should be.
If you need to cancel, don't.
Speaker 3 (11:21):
That's like one of the seven naughty words.
We don't use that word.
So, like what we train our teamto do is, when they're calling
patients to say, like we don'teven say we have a cancellation
list.
We were able to move somethings around and now have an
opening for this time.
Does this time work for you?
I don't want that word comingout of anyone's mouth.
Speaker 1 (11:45):
It's just part of our bread.
What's something that I thinkis crucial to go through is what
is acceptable and what'sunacceptable.
You know one discussion I hadwith my team.
We said 24 hours.
A lot of people are 48.
What are you guys?
Just really quick 48.
48.
Okay, so we're 24.
We did 24 just to make itreally easy and we just never
changed it.
And I'm curious like we want totreat everybody the same and we
want to say that to our patients.
Hey, we don't want to have tomake decisions, we want the only
(12:08):
way to be fair with everybodyis just have it be black and
white.
But what do you say to someonewho says someone was had to get
rushed to the hospital, afuneral, someone passed away,
Like I mean, is it so cut anddry that there's no exception
for bending?
Because what I struggle withwith my team is that if we allow
them to bend a little bit, it'sjust like they just blow it
open.
They take it to the next level.
(12:29):
That's just like now.
It's like damn it, that's notwhat I wanted.
What do you guys think of that?
Speaker 3 (12:33):
So for us, one of our values is it's never the wrong
thing to do the right thing.
So we can apply this to ourcancellation policy and if
someone calls and says I need totake my mom to the hospital or
I'm not feeling good or whatever, and I could go up to that team
member and say why is henry nothere today?
And they're like, oh they, theyhad to do.
(12:53):
Did you push back?
No, it was the right thing todo.
He really seemed like he was ina panic.
End of discussion, that's ityeah and that's again.
I understand the black andwhiteness and team members love
having that black and whitepolicy, but people are not black
and white and if we start totreat them like that, then I
feel in my world at least, Ifeel like that we start treating
(13:18):
patients more like numbers asopposed to understanding what
they're going through and wherethey're at.
So the black and whiteness ofwhat I'm trying to create is I
have enough trust in the personon the phone and if they think
that's the right thing to do,that's the right thing to do.
With that being said, we can'thave repeat offenders.
So, yes, it's okay if someonecalls out sick once every two or
(13:42):
three years maybe, but within18 months if we've had to move
their appointment more than twotimes, we're too busy for that.
That's not fair.
The policy that we have is yes,we have leniency, but we can't
have the expectation that thisperson's not going to show and
we need to track how many timesthey're either moving their
appointment or no showing.
Speaker 1 (14:02):
What if someone sounds really sick man I just I
can't come in.
Oh, can't make it, Don't comein.
Is that a violation?
Yes, that's a charge.
Speaker 3 (14:12):
It's not a violation.
I'm so sorry you're sick.
I do want you to know.
We're booking out like 10months and we probably won't be
able to get you in.
Do you want me to put you onASIP list?
Are you sure there's any wayyou can come into this
appointment?
How do you want me to best helpyou and then help navigate the
conversation?
I don't think it's ever helpfulfor us to be like.
This is our cancellation policy.
(14:34):
Yes, I understand it, but thepatient on the other side
doesn't want to hear that.
They just want to be helped.
Speaker 1 (14:44):
It's just so hard.
Because I struggle with thisand I think a lot of practice
owners can relate to it is Iwant my team to use their brains
and I want them to do the rightthing, and I will never shame
them for allowing somebody someleniency and making exceptions.
But it drives me crazy whenthose exceptions become so
consistent that it's like youjust didn't want to have a
difficult conversation.
Speaker 3 (15:03):
But that's the training when we found most,
besides having those high-riskpatients need to actually call
back the office, the little bitof pushback and says just say,
if someone calls and says I'm sosick, I'm so sorry, I hope
you're okay, you sure there'sany way you can make it today.
I'm booking out so far.
And if they still say like no,no, no, okay, all right, do you
want me to give you a call backor do you want to try to
(15:24):
schedule that now Because,honestly, we can't see it till
February Again, I think some ofthat that starts with training
our team and then us as doctors,backing them up with the
decision that they made and notNot poopooing it.
Speaker 2 (15:38):
You know, this is a great conversation, and I think
we could have this with 10, 20doctors, and we're all going to
have different perspectives,right?
This is the beauty of being abusiness owner there's nobody
who's right, nobody has theright answer and nobody has the
wrong answer.
It's all about what reallyworks and what do you feel
strongly about.
You know we have our policy,that it's a little bit black and
white, I'll be honest with you,and I work two days a week, so
(16:07):
if there's ever an exceptionthat needs to be made, they're
going to reach out to me.
You know they're going to textme and they're going to ask me
whatever, and knock on wood, Ihaven't got any question like
that.
I can't remember.
So it must be working.
Speaker 1 (16:14):
Yeah, right, see, I hate that.
I hate when you let me ask theowner and I tell my team do not
do that to me, because then youjust immediately make me look
like an a-hole if I say no.
Speaker 2 (16:24):
Well, I've empowered them to make good decisions and
do the right thing.
But the policy is pretty blackand white Gosh.
Maybe like a year ago there waslike somebody who I really knew
patient's been in the practicefor a long time and I kind of
did what you said, steve.
I said you know what?
Let's give them some grace Gosh, what let's give them some
grace Gosh.
They've been a practice so long, so there's never going to be a
right answer here.
But I think what has worked forme was to make the policy that
(16:46):
the team agrees with, the teamis on board with, and we'll
stand behind and stand behind it.
Don't wiggle one way or theother, or else you're going to
get everybody that takesadvantage of it.
Speaker 1 (16:56):
Yeah, I'm just curious for your situation.
You're asking for a deposit,which I think a lot of people
would love to do for hygiene.
Our solution we have rarelyhave a failure reschedule.
On the doctor side, we'retrying to collect the whole
patient copay.
We take half that as ourrequirement but we try to
collect all of it because weknow when we collect all of it,
when that person comes in thatday it's going to be a better
(17:16):
experience.
They won't ask questions abouttheir insurance coverage, they
won't have any financialquestions.
We get all that out of the wayand we'll tell the patient.
We like to get the financialstuff out of the way so that we
can stay on time the day of theappointment.
So all of our we're an on-timeoffice.
But I'm curious how your teamis presenting this deposit.
Like there's got to be someverbal training and there's got
to be a way to do it.
(17:36):
And I'm just I'm curious whatthey say.
Speaker 2 (17:42):
So with hygiene it's almost like a joke, right?
You make it like a fun thing,right?
We only do it for hygiene onSaturday hygiene appointments.
So not every day, not every day, just Saturday.
Because what we noticed was allof a sudden it's a nice day
outside and stuff like that, andall of a sudden your Saturday
hygiene, which had three or fourcolumns, all of a sudden like
half of it's gone.
So we did it just for thatpurpose and we joke around with
(18:02):
the patients like listen, it'skind of like sitting in first
class.
No other offices are open onSaturday.
You're getting to come in andget your teeth cleaned.
All that we're asking is a $50deposit to reserve that time in
first class for you, and they'reall fine with it.
And, like I said, I think it'sto the point now where people
have their deposits on file andthey just leave them for the
next one, for the next one.
Speaker 1 (18:23):
Yeah, I think I want to do this at my office and I
want to do it for appointmentsafter four o'clock because it's
such a high priority time.
And I mean we've got peoplescheduling three, four
appointments ahead of time, Likethey're scheduling their next
two years of appointments, andit's like I don't mind doing
that, but at the same time it'slike I don't know it's such a
give and take of trying to beaccommodating and not getting
(18:45):
abused at the same time.
Speaker 2 (18:47):
It seems that analogy works well with the patients.
You mentioned it, steve too.
We're.
Hey, we're really popular,we're.
Our Saturday appointments arebooked out for eight, 10 months,
you know.
So if you want to reserve thattime, I would highly suggest we
do it, and all we ask is a $50deposit, right?
Speaker 1 (19:02):
Yeah, and, like Henry said, there's no right or wrong
answer.
It's just you've got to havesomething, you've got to discuss
it as a team and you've got tostick to it.
Consistency it's so importantin everything we do, consistency
.
I'm going to let you do thefinal thoughts, steve.
What do you?
Speaker 3 (19:16):
think I think for any policy, especially the
cancellation policy, because Ithink we hammered home how
important it is the team needsto know exactly what it is.
You need to train how you wantthose situations to be handled
and then you need to followthrough on what you said you
were going to do and thepatients who want to be there
(19:37):
will be there and don't fight.
My recommendation would bedon't make fights over $75 or
$50.
Let those patients go fightwith someone else.
Speaker 2 (19:47):
Totally, henry.
Final thoughts yeah, love it.
Don't want those patients inyour office when you've got a
growing, successful, happypractice.
We don't need those people thatare just the vampires of our
time.
Have the policy in place, stickwith it and don't be afraid to
revisit it.
You know, we revisited beforeand now we found something that
(20:08):
really works and we'reconsistent with it.
Speaker 1 (20:09):
It's a great point, awesome.
Well, if you are listening andyou're thinking, this is the
year you're going to get yourpractice to run without you and
have it be smooth, flowing,systematized this is the kind of
stuff we do at Dental PracticeHeroes.
Go check out our website,dentalpracticeheroescom and see
what coaching packages we have.
We want to help you live abetter life and be better in
every regard because of yourpractice, so that's what we're
(20:30):
here for.
Go check us out.
Thank you so much for listening.
We'll talk to you next time.
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
CrimeLess: Hillbilly Heist
It’s 1996 in rural North Carolina, and an oddball crew makes history when they pull off America’s third largest cash heist. But it’s all downhill from there. Join host Johnny Knoxville as he unspools a wild and woolly tale about a group of regular ‘ol folks who risked it all for a chance at a better life. CrimeLess: Hillbilly Heist answers the question: what would you do with 17.3 million dollars? The answer includes diamond rings, mansions, velvet Elvis paintings, plus a run for the border, murder-for-hire-plots, and FBI busts.