How to reduce patient no shows and cancellations?

No shows and cancellations can sometimes feel like times when you’ve made plans with someone months or weeks in advance only to have them cancel at the last minute. And then you’re scrambling to figure out a backup plan, if you didn’t already have one. In the case of no shows or cancellations, not only is it disappointing, it’s also a patient missing out on getting the care they need and losing revenue.  

No shows and cancellations are occurring more often than they used to. In the October 2022 Economic Outlook and Emerging Issues in Dentistry study, they were some of the most common reasons practices couldn’t maintain a full schedule. 81.8% were due to no-shows or same day cancellations. 42.3% were cancellations more than 24 hours out.  

No shows or cancellations will happen occasionally, but there are steps you can take to reduce them at your dental practice. Learn why your patients may be leaving your practice chairs empty and what to do about it.

Determining the Root Cause of No Shows and Cancellations:

Start with understanding the reasons behind why patients are missing their appointments. Patients will have different issues or events that are causing them to cancel but identifying common causes will help you take more effective action.

Some reasons a patient may no show or cancel include:

• Patients could forget or are busy, and sometimes double book themselves.
• They could be nervous about the procedure or treatment. Maybe they had a bad experience in the past that remains with them.  
• Your patients are worried about the expense of a procedure they’ve scheduled or are unclear about their insurance coverage.  
• Patients who frequently no show or cancel may just not understand the importance of their appointments and oral health needs.
• You might have seasonal patients who prefer to come during specific times of the year, but end up not coming because something else came up.  

After determining the most frequent causes of no shows and cancellations at your practice, you can form a plan to address the different reasons that patients aren’t showing up. You may find it helpful to group patients who frequently no show or cancel by their reasons. That way, you can handle each case thoughtfully and effectively to reduce your practice no show and cancellation rates.

Here’s some examples of how you can handle these different patients.  

1. For the busy patients who forget their appointments or double book themselves

For these patients, their appointments may not always be top of mind, especially if they scheduled their cleaning months in advance. These patients will benefit from frequent reminders leading up to their scheduled appointments. Determine their preferred method of communication and set reminders accordingly. If your practice isn’t already utilizing a tool like appointment reminders, it may take some time before you find the “sweet spot” for reminders, that is, the number of reminders that’s most effective for patients without overwhelming them.  

What else you should do:

• Reinforce your no-show and cancellation policy: Hold patients accountable by reminding them of your no-show and cancellation policy, which should include a fee when they do either. Patients are more likely to show up if they’re know they’re subject to a fee. Even if a patient doesn’t show up, at least you’re recouping some of the revenue you lost.  
• Offer pre-paid appointments: Think of it like a hotel or Air BnB deposit where you collect some revenue in advance. This will motivate patients to keep their appointments.
• Communicate scarcity: Your message should be around limited appointments so it encourages patients to keep an appointment knowing it could be difficult to get another one in the immediate future. Rescheduling appointments can be a nightmare for busy patients.  

2. For the nervous patients

Another reason a patient might no show or cancel is nerves. About 1/3 of the US population avoids dental visits due to a fear or anxiety, so dental teams should be prepared to make the practice experience as comfortable as possible leading up to it and, of course, during it. These patients require more personalized communications and thoughtful patient education depending on the treatments they require. Putting them at ease instills a strong level of trust that could help them overcome that fear or anxiety.  

What else you should do:

• Give the patient a call: Have the doctor or hygienist contact them prior to the appointment to find out if they have any questions or concerns. While this might be something that’s outside your clinical team’s scope, it could make a difference in convincing a patient not to cancel their appointment. Demonstrating this level of attention, empathy, and understanding goes a long way to cultivate a better doctor patient relationship.  
• Send an ‘intro to the practice’ email: This can be a written communication or a video embedded in your email. You can walk new patients through what to expect at their appointment, depending on the type. This is a good way for them to prepare and set expectations to ease nerves.  

• Remind them about your practice policy: If the patient still isn’t ready to commit to an appointment, explain that it’s better not to schedule an appointment until they’re comfortable. You can kindly, but firmly explain that by scheduling an appointment, they could be preventing someone else from taking that spot who needs the care.

3. For the cost-conscious patients

Your patients (and probably you too) feel the cost burden of healthcare. There are ways to show understanding for these patients, so they feel comfortable coming to your practice when they need care. These patients require a strong understanding of their finance options and thoughtful patient education that helps them be proactive in their oral health and shows they have options to pay for treatments.

What else you should do:  

• Communicate the different payment options you offer: Hopefully your practice offers a variety of ways for patients to pay for their oral care. This can include third-party finance like CareCredit or a dental membership program – to name a few. Accepting different payment types also goes a long way. Don’t be afraid to accept cash or check if a patient can’t provide a credit card to pay.  
• Offer phased treatment options: Phasing out treatment plans can also ease the cost burden for patients. Sometimes seeing the full cost of treatment can be alarming and stress patients out. If your practice can offer phased treatment plan options, this allows you to get paid and ensure your patients get care that helps.  

• Educate them on preventative care: Not accepting a treatment due to the cost could prevent them from seeing the importance of it, particularly if it’s a treatment that could protect them from long-term or worsening oral health problems. Patient education can change a person’s outlook on the treatment or procedure if it’s thoughtful and presented in the right format. Your patients process information in different ways, and it takes time for it to sink in. That’s why patient education should start even before the patient is in the chair. With tools like ADA TV, you can have better conversations using visuals and tutorials to explain what could happen if they choose to delay a treatment that’s necessary.  
  

4. For the seasonal patients

You probably have patients who prefer to come during specific times of the year – be it the end of the year and/or the holiday season, summertime, etc., but somehow end up cancelling for various reasons. One way to motivate these patients to keep their appointments is sending them timely campaigns and promotions your practice runs. This can motivate them to come to their appointment, so they stay on your schedule and keep their oral health a priority.  

Here's what to do for them:

• Create timely campaigns: Sending an expiring benefits reminder or an end of the year promotion on teeth whitening.  
• Offer pre-paid appointments: If patients have to pay ahead of time, they are more likely to keep their appointments. It solidifies their plans knowing they could lose money for not showing up.  
• Give them more appointment times: During certain times of the year, like the holiday season, it might be worthwhile to expand your appointment time slots to squeeze in last-minute patients and ones who can’t come during your normal practice hours. Offering this flexibility during seasonal times of the year could encourage patients to keep their appointments.  

These are a handful of ways you can handle patients and some of these tips can be used for the same groups. All these patients require a combination of tools and clear and frequent communication to encourage them to keep their appointment, but it starts with understanding the ‘why’ behind them.  

Find out what works for your patients and document it so your entire team can refer to it the next time they have a no show or cancellation. While no shows and cancellations can’t be eliminated, it’s possible to significantly reduce them so it’s not having the same impact on your bottom line as it once was. And to know if what you’ve implemented is working, you need to be tracking it closely. No shows and cancellations are two outcomes that impact your ability to retain patients, but they aren’t the only ones.