Cancellation Fee


When returning from events, our team reconvenes for the follow-up, evaluation and evolution of the information we’ve delivered. Our presentations cover several topics that often ignite a series of questions from the audience. Being able to motivate our audience to cross the wide chasm of change is why we do what we do. Inevitably, there are concepts which some attendees will be hearing for the first time.

One of the topics which elicits a notable number of gasps is when I suggest they return to their offices on Monday and immediately rid themselves of their office cancellation fee.

“But our schedule is full of holes”     “What about the patients who call us last-minute?”       “So we’re supposed to just let the no-shows get away with it?”     “How am I supposed to pay my hygienist when she doesn’t have a patient?”

All of these questions seem perfectly reasonable. After all, one of the top concerns we hear from dentists is “My schedule looks like Swiss cheese!”

What I am about to share with you is important. Your cancellation fee is actually part of the problem. And the more frequently it is used, the solution to your schedule challenge will remain an enigma.

Let’s have a look at the main reasons these openings occur: 

Last-minute conflicts

We all know what it’s like when a wrench is thrown into our calendar. Perhaps your patient has been called into work. Not everyone has the ability to say to their employer, “I can be there, except during 9:30 to 11:30 for my dentist appointment” especially if they need the money. Or what if their child’s school calls to say their child is ill or injured and they’re the only one available. Or traffic on the interstate is blocked due to an accident. My goodness, we’ve all been there and it’s a stressful feeling knowing we have to change a pre-scheduled appointment. I promise you, when one has to make the call to say “I won’t be able to make it to my appointment” because of one of these occurrences, the last thing they need to hear is “You will be billed for a missed appointment fee of $50.00”


And what about the patient who calls with an emergency. Or a cancelled flight. Or a death. Or “I just don’t feel like coming to a dentist appointment today…too stressful”. Regardless of what you may think constitutes an emergency…you don’t get to decide. Only the patient can make this call.

MoneyMany of us have experienced the last-minute call from our patient saying, “I can’t afford today’s visit”. Hmmm…the day of the appointment is a fine time to come to that realization! Imagine hearing a receptionist respond to this with, “Well Mr. Jones, I am going to have to assess our $50 cancellation fee because of your short notice”

The No Show

These patients are our fly-under-the-radar-and-drop-the-stealth-bomb patients. As we all stand around looking at the clock 10, 20, 30, and BOMB! Worse yet, most of us know exactly who those patients are! So we serve up another cancellation fee. 

Believe me, I understand the frustration when the above leave us with a schedule that looks like it was shot up in the war. But just for a moment…take off your defensive glasses and put on your customer service lenses for the duration of this blog.

Why are we allowing our chronic no-show patients to schedule appointments in advance? That’s not to say that your unorganized patients don’t deserve dentistry, but rather we must handle their appointments differently. In other words, these patients require us to be experts in scheduling in addition to creating value. They require us to work outside of what we normally do.

Consider placing these people on your short call list and offering this. “John, with your busy schedule it seems that scheduling in advance is challenging. I’ll put you on our VIP list and give you a call when a short notice opportunity arises?” By offering this option, what we have done here is leave John with his integrity in tact and we have taken control of our schedule for patients who keep their commitments in a positive way. We have just determined the best way to schedule John in our office in the least disruptive way. 

Recently, I was caught up in the middle of an unprecedented airline debacle with a company whose tag line is “We’re a customer service company that just happens to fly airplanes”. This was such a debilitating event for them and what was exposed throughout the drama was that their customer service training was mediocre. You see, anyone can provide good customer service when things go right. But things go wrong…and in a big way…THAT is the testament to how good or not-so-good the customer service team is trained.

In a dental office the same applies. It’s easy to treat people great, using excellent customer service skills when things go according to plan (i.e. a nice productive, full schedule of happily paying patients) but the true test is when things don’t go according to plan. (i.e. the patients start dropping like flies off of the schedule for the day) 

It’s equally easy to throw the “Cancellation Fee” at these patients to remind them “Doctor’s time is valuable” or “We set aside an hour for you today” or one of the worst of all “Doctor is paying his team to be here” (Yikes! I would hope so!) But what if we take this opportunity to do some self-reflection and evaluate the success rate of our processes.

How about the patient who calls last-minute because they cannot afford the visit? Again, if we have our customer service glasses on, how might we have mitigated this disruption to our schedule? Having a person who understands the fine nuances when setting financial plans is critical. Have we truly evaluated the patient’s ability to pay for the treatment or have we hastily scheduled in order to fill our day. Was there a clue? Perhaps we could have collected at the time the patient scheduled? 

The cancellation fee is nothing more than a way to offend or upset your patient. Equally important is that if you were to ask yourselves the question “What is $50.00 going to do for the time lost”? you’ll undoubtedly find the answer to be “Not much”! And in reality, if you’re able to collect, is it worth the team time, statement or phone call that has reduced it to $27.50? Can that buy your team a Starbucks? Not likely…and it certainly won’t keep the lights on. But what it will do is leave a bad taste in your patient’s mouth. 

People buy things they value from people they trust. Your patients may trust you whole-heartedly, but they don’t come to your offices with pre-loaded value for treatment. So it’s up to us to create that value. Creating value begins when the patient calls our office for the first time and at every touch point from that moment on.

For example, when we ask our patient to commit to an appointment following their hygiene visit we want them to want to commit. The way to help them get to that point is to have handled any pushback before it occurred, answered questions, prepped he/she for the financial consult and helped the patient value the difference between a body that is sick and infected vs. a healthy one. These are all important pieces of the value puzzle. 

Building value doesn’t happen if we spend our appointments discussing the weather, the weekend or our upcoming family reunion. We have to work diligently to help our patients value the important work we do. And it requires methodical processes, assessments and time management.

I work with clients who have stopped confirming appointments except by request. When a patient values the appointment they will make it a priority in their calendar too.

When a patient doesn’t prioritize their commitments to our schedule we ought to view it as an opportunity to evaluate ourselves and our processes. Are we providing ample time for our hygiene appointments to provide five-star care? Is our new patient process comprehensive and does it provide an excellent experience? Does the assistant and dentist carry on a personal conversation over the patient during a crown prep or are they focused and concerned about the patient’s comfort? Does your front office team have a cancellation mitigation process and are they trained in guiding patients to where the schedule needs them to be vs. where the patient prefers? Is this a patient who would find himself seeking the services of another dental practice?

Is your cancellation fee is shining a bright light on your customer service or casting a shadow on you and your team? We believe it is the latter and encourage you to try something new and service oriented! Continuously evaluate your processes and evolve using the information gleaned from each day. 

We cannot become what we want, by remaining what we are. This requires a clear focus and constant massage of our current practices.

If you would like more information on how to remove the fee and get those patients to keep their appointments, give us a shout. And if you like what you’re reading…give the compliment of sharing with others.

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