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It's not about you. Or is it?

Sept. 13, 2022
What’s the most important factor in ensuring patients keep their dental appointments? If your first thought is confirmation calls or texts, think again—it’s not about your system.

Ask yourself: What is the most important factor in ensuring patients keep their dental appointments? If your first thought is “confirmation calls or texts,” you would not be alone. But you would be wrong!

When we experience a no-show in our schedules, the first thing many of us look to is the confirmation list. “Did we speak to the patient or leave a message?” “Home or cell?” “Do we have a good phone number?”

Another element on which we rely heavily is the recall system the office uses. “Did the patient receive a reminder card in the mail?” “Were they properly entered into our continuing care system?”

Recall systems and confirmation calls are necessary components of a healthy hygiene department, of course. However, they are just that: components and complements to the real factor that helps ensure patients make and keep appointments.

Surprisingly, it’s not your system. It’s you.

Your relationship with your patients determines whether they make appointments and keep them. If you don’t agree with this, I challenge you to think about the appointments in your own life that you never want to miss. Do you have a friendly hair stylist you would never stand up? A personal trainer who gives you the push you need to be your best? A much-needed massage with the masseuse who knows where your muscle pain is located? These are all relationships. Not deep or complicated ones, but important ones in your life.

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In contrast, think of some appointments you’re tempted to reschedule or not even show up for when life gets busy. The terse and unsympathetic DMV staff. A physician who is always curt and rushed with the staff who seem overwhelmed and disinterested. The nail salon where you see a different technician each time you visit. Why do we make time for one and not the other?

I had the pleasure of spending a week in a delightful private practice. A casual observer would not have noticed anything remarkable about this practice. First, the office itself was small and in need of updating. The staff was tiny with just one doctor whose wife worked the front desk. The technology was good, but certainly not cutting-edge. The practice didn’t sponsor Little League teams or community 5Ks. It closed at 4:30 p.m., offering no extended hours. The recall system was adequate, but not complicated. The short call list was (gasp!) a spiral notebook. Patients received reminder cards by snail mail, not texts or emails. Despite all of this, this practice had something remarkable.

In the seven days I spent with them, neither the doctor nor hygienist had a no-show. One patient canceled, but that person called ahead. The practice’s overall schedule utilization in the past year was more than 90%.

There was a good deal of competition in the area. I counted at least five dentists within two miles—and one was right next door! The patients I noticed were not folks with nothing better to do than visit the dentist. They were not wealthy. They were busy families with kids and teens; young professionals with crazy schedules; baby boomers who worked, traveled, and had kids home from college; and elderly parents who needed help.

So why was everyone showing up?

It was remarkably simple, really. So simple, in fact, that I questioned it. But there it was. The doctor saw every hygiene patient, if only for a couple of minutes. He and the team asked about the patients’ lives and families. In morning huddles, the staff spoke about their patients as if they were close friends. Patients were cheerfully greeted by name when they walked in. Each member of the team sat down to talk to patients; they took off their masks and looked them in the eye. They listened more than they talked. They were honest. Patients felt cared about because they were, and they knew it.

The hygienist’s 4 p.m. patient was not her “scaling and root planing.” It was Mrs. Jenkins. The doctor’s 10 a.m. patient was not his “crown seat.” It was Bob Johns. The 11 a.m. patient was not “the last patient before lunch.” It was Shirley Smith.

All of this may sound quaint and overly simplistic, but there is no denying that this type of patient treatment works. I have spent time in practices that had state-of-the-art recall systems with text reminders and that had spent thousands on marketing and office decor. In many of those cases, no-shows and cancellations were still an ever-present concern. Why? Because their patients did not attach any emotion to their dental visits. It was just another appointment. Pleasant and important, yes, but not special enough to make it a priority. No amount of marketing, calling, texting, or educating will keep patients coming back if they don’t feel that you genuinely care about them.

Spend a few minutes thinking about those appointments you never miss and ask yourself why you not only keep them but look forward to them. You may discover there is more emotion attached to those relationships than you realized.

What can you do to make sure your patients wouldn’t dream of missing an appointment with you?

Editor's note: Originally posted in 2018; updated September 2022

About the Author

Andrea Kowalczyk, BS, RDH

Andrea Kowalczyk, BS, RDH, currently the director of dental hygiene for a national dental support organization, has extensive experience as a dental hygiene director for large dental groups. She creates and presents continuing education courses for dental professionals and has a special interest in assessing patients' unique risks for dental decay. Her articles have appeared in publications including RDH and First Impressions magazines.