Does Your Schedule look like swiss cheese?

Is your office experiencing “holes” in the schedule?  Are you having “no shows” in hygiene and rejections to treatment recommendations even though you are able to provide services that meet your client’s described outcomes?  Welcome to the “new normal” according to a recent Health Policy Institute[1] article.  Between 2005 and 2013 the HPI statistics show a continuing decline in adult dental care utilization rates for all income levels.  Here are several things we are doing to counteract this trend in our office.
Many speakers are talking about “Five Star Service” and “Five Star Google Reviews” as the key to a full schedule.  Dr. Michael Abernathy[2], who has surveyed over 18,000 patients, points out those patients already expect five star services in our offices. In difficult times we go back to basics.

1. Pre—book hygiene patients before they leave the hygiene room.  If someone says “I don’t know my schedule” the hygienist should say, “I do know mine and I would like to have you in it.  Let’s make sure you have an appointment now.  If you have to change it later I will be able to move folks around to meet your needs rather than trying to find a hole in my schedule.”   A busy hygiene schedule is the key to a busy restorative schedule.
2. Make post-operative phone calls.  Ideally the doctor should make follow up calls after any treatment that might involve lingering discomfort. We make them in the evening or the following day, depending on what the client wants.  We also give the client a card with our cell phone number and instructions to call us anytime if they are unsure about their situation.  The calls take little time and are a huge factor in client satisfaction. 
3. Use pre-block scheduling.  We hold blocks of time in the schedule for highly productive procedures.  We do not fill those times with anything else until the day before if they are not booked.  By pre-blocking times for high production procedures we are controlling the work flow for the doctor and staff for lower stress and better profitability. That way we also always have the ability to take care of the broken tooth that needs a crown or endontics quickly.
4. Pre-block specific times of each day for urgent care. Do not appoint these times until that day!  Being seen quickly when needed is a major item in patient satisfaction.  Patients with true urgent care needs will make time in their day to meet our schedule.  That way when they do arrive there is no waiting and the office is not stressed by trying to “work someone in”. 
5. Patients calling for a new patient exam will be seen within two weeks unless their schedule requires otherwise.  Patients coming in for a new patient exam will be offered a hygiene appointment the same day if the wish it and we can accommodate it and they have time available,  Our new patient exam is comprehensive and requires about 90 minutes of patient time.
6. We make coming to our office a “user friendly” experience.  We try to have convenient office hours.  In our case we are open every day by 7am.  For extensive cases we may work around the patient’s schedule.  We practice excellent telephone skills, utilize current technology like text messages for appointment reminders for those who wish them, use photos and videos for patient education,  We openly discuss fees and provide a variety of ways to make dental care affordable.   We run on time!  We respect our client’s time and make sure that they know it.
7. We communicate with our clients.  When we know we have pleased a client we openly ask them for referrals, and we personally thank them when they do refer.  We send out quarterly newsletters with information about the office that reinforces the idea that our patients are a part of our dental “family”.  We are a part of the community outside the office – giving back through charity and community service.
8. Finally, if things are really slow.  Take a day off.  Look at the schedule and be honest.  Could you be more effective if you blocked off a day and worked hard for the balance of the week?  Have your staff reschedule you effectively.  Get out of the office and do something fun rather than sitting around waiting for the phone to ring.  Go take a course in a new service you would like to offer.  When you show up for work looking forward to a busy day everyone will be more positive – you, staff and clients.

For a myriad of reasons the new normal in spending on adult dental care may be a lower number than we would like.  In the world of private practice fee for service care we must present a very high perceived value to our clients to keep them coming for care on a regular basis.  There is no “magic app” or psychological trick to make it better.  Stick with care, skill, judgement and respect.
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[1] Gap in Dental Care Utilization Between Medicaid and Privately Insured Children Narrows, Remains Large for Adults , HPI, October 2015

[2] Summit Dental Practice Solutions, Dr. M. Abarnathy, Dallas, Tx,2012