Professional Courtesy: Flake Repellant by Dr. Thomas Giacobbi

Professional Courtesy: Flake Repellant


by Thomas Giacobbi, DDS, FAGD, editorial director


Most of my days start with breakfast and The Wall Street Journal. A headline in the May 4 issue caught my eye: “Welcome to the Era of ‘No-Show’ Fees.” This topic often surfaces in online discussions at Dentaltown, and if you’ve been sitting on the sidelines, you may want to reconsider your position.

The gist of the article: More and more service providers are charging fees for last-minute cancellations, no-shows and the kind of patients who routinely flake out. The article featured providers across a range of industries, from barbers and stylists to daycare centers, housecleaning services and restaurants. A sign posted in the barber shop summed up the justification for charging a fee the best: “No call, no show; you stole my time and money! If you want to rebook, I need one of them back!”

This is very true in our world as well. We know most patients will show up most of the time, but a lax policy on no-shows and reschedulings will train your patients to make your appointment a low priority in their day. We all have patients who take advantage of us, and instituting a no-show fee policy is a nice way to get their attention. My practice now charges a flat $60 fee; in years past, we did it based on the length of the appointment ($1 per minute). Patients are warned multiple times, and each time it is documented.

Your practice administrators need to have the leeway to give patients a pass when a legitimate emergency occurs. Once a patient has exhausted our good will and is charged a fee, the good ones will pay the penalty and pay more attention to their future appointments. The patients who have no intention of doing better will likely move on to another practice. In more extreme cases, we invite them to move on with a dismissal letter.

Of course, a dental practice was mentioned in the article and not in the most flattering light. In this example, a patient was frustrated because her dental office called her to cancel her appointment, for the second time in a row, while she was en route to the office. Her comment in the article: “I spent time and energy and gas money trying to go to an appointment. You guys charge a cancellation fee, but I don’t get to charge you one.”

She makes a good point. If you’re going to have a strict policy with your patients, you should reciprocate when you have inconvenienced them. Sure, dental offices have reasons they need to cancel, but this office doing it twice in a row could have earned some grace by offering to waive a couple future no-show fees or simply put a credit on the patient’s account.

Charging a no-show fee is not for your practice if you frequently cancel patient appointments or move them around on short notice. You have other issues to solve. Also, if your schedule is full of holes, you need to be focused more on patient retention than discipline. In these cases, I would say that a no-show fee is something to aspire to, because it is the best indicator that your time has become too valuable to waste.

Does your team have a policy they wish you would adopt in the practice? Have any stories of good policies gone bad? Please share your comments online or reach me by email at tom@dentaltown.com.


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