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Endo Mastery

Day: June 16, 2021

PREVENTING NO SHOWS AND CANCELLATIONS

DEBRA MILLER | DIRECTOR OF COACHING

An appointment that is broken by a cancellation or no show has a high cost in the endodontic practice. Practices invest a lot of time before the patient even comes in because the objective during the appointing process to make sure the patient is prepared for treatment on the same day when the diagnosis is made. In effect, endo teams work hard for the patient to “pre-accept” and be ready for potential treatment as soon it is diagnosed. For this reason, we talk to the patient, we do over-the-phone triage and symptoms assessment, and we pre-estimate insurance amounts and copays.

 

When a patient cancels their appointment, we have to do all that work again … assuming they cancel early enough that we have enough time to fill the appointment time with a different patient. If we don’t have enough time, or if the patient simply no shows, then the cost to the practice is the highest. The doctor will be idle, and a treatment fee will not be collected for that appointment time.

 

In the past year, during the height of the pandemic, we adapted to the fact that many patients were experiencing anxiety. Now, as states open up again, we would expect patient behaviors to return to normal. But that has not happened yet. One reason is that there are lingering financial effects from the pandemic, and financial reasons are a huge driver of cancellations and no shows. Also, and expectedly, there are always patients who have a fear of treatment itself.

 

When taking a cancellation call from a patient, you need to keep them in the schedule because if you let them “call you back”, they never will. Be a detective and find out why they are canceling. Ask open-ended questions and listen carefully to their responses. Sometimes the real reason is just below the surface. A lot of patients may feel embarrassed or reluctant to say it is a financial issue. Be prepared to suggest third party financing options and tell patients, “Right now, your finances are temporary but if you lose the tooth, it is permanent.” Express genuine concern for the patient and their health.

 

Another idea is to make sure at the time of scheduling that you tell patients their appointment is now confirmed. Although we often describe “confirmation” as the call or text message the day before an appointment, these are actually reminders or notifications done for the courtesy of the patient. A subtle shift in language will strengthen the patient commitment to their appointment, rather than seeing the “confirmation” as an opportunity to cancel or reschedule. This will also help with no shows.

 

For no shows, remember that those patients often come from doctors who allow no shows. You can reach out to the admin team at those offices to ask them (in a friendly way) if they would like to share and collaborate on ideas you both can use to prevent no shows. Also remember that when a patient no shows you should notify the referring office immediately since it will put a damper on their treatment plan with the patient.

 

Your reminder system (“confirmations”) should take advantage of current technology and ask patients how they would like to be contacted. For more and more patients, texting is the most favorable. Check your software options or a third-party solution. Also, review the message you are sending. Rather than “We are confirming your appointment for tomorrow.”, try “We calling to see if you have any questions about your visit to our office tomorrow or questions about your estimated co-pay.”

 

Finally, when a patient no shows, make a follow up call right away (if they haven’t arrived within 10 minutes of when expected). The goal is to get them back in the schedule as soon as possible. Ask them “Is everything okay? We were expecting you and I’m concerned something has happened.” Again, when this is done with genuine care, it will open the conversation to find out what happened and schedule them again appropriately.

THE CONSEQUENCES OF BUSINESS GROWTH

DEBRA MILLER | DIRECTOR OF COACHING

One thing that doctors have in common with every business owner is the desire for predictability. Clinically, you want predictable outcomes. Similarly in our businesses, we want predictable and reliable operations that consistently result in business success.

Whenever you contemplate making changes in your business, it’s natural to consider the risks. As the Ethiopian wisdom suggests, it’s prudent to consider how changes might have a ripple effect. What interconnections in systems and procedures will also be affected? Are there hidden traps or surprises that might occur? How will team members react and respond?

Prior to making even the best-intended changes, it’s impossible to know every side effect and consequence. And that means it’s very easy to get caught up in imagining the worst what-if scenarios and getting stuck in analysis paralysis trying to predict and plan for every contingency.

The vital point to remember is there is an important difference between knowing the consequences in advance (which are unknowable) versus being prepared to deal with the consequences. Being prepared means that you expect some bumps in the road will occur. You expect some disturbances in the daily flow that will need to be ironed out. You expect that some team members may need extra training or leadership attention to make them comfortable or to see the positives.

I still believe that looking ahead reasonably and thoughtfully is something every business leader should do. But how much weight you put on the “unknown consequences” should be tempered by how necessary or beneficial the objective of any change will be.

The one area where, as a business owner, you should always be ready to embrace inevitable disturbances is change motivated to grow the business. Growth year-over-year is a necessity for a healthy business, and a sign of effective leadership. If you aren’t on track for successive growth, then you are on track to declining value, which will eventually result in reduced profitability.

We see this pattern all the time in practices. Doctors invest in growth and embrace change in the first third of their career. Then they start to taper off, then level out into an extended comfort zone that fluctuates up and down. And then, after a while, they either recommit and re-energize around new growth or they begin to decline slowly.

Every doctor is different. They are going to rise to their comfort zone based on what they can self-implement. Then, they’ll either stay there until they start declining, or they commit to bring in better expertise, support and resources to “level up”. It is truly a moment of deciding to be prepared for the consequences of business growth, but it is made easier when guided by experienced mentors and coaches.

MARKETING TIP: TOP OF MIND AWARENESS

For any product or service to succeed, it needs a marketing strategy. Marketing is the process of making potential customers/clients aware of what you offer and how to get it. There are lots of ways to do this, from advertising to direct marketing to social media to relationship marketing.

For endodontists, your clients are primarily GPs based around a professional, interdisciplinary doctor-to-doctor relationship and patient referrals, so relationship marketing is hugely important. In an ideal referral relationship, GPs would rather refer out all endodontic treatment than attempt it themselves, and they prefer to refer it to you (rather than another endodontist) if at all possible. You have “top of mind awareness” for their endodontic referrals, and that probably describes your best referrers pretty well.

Best referrers are the minority though. Most of your referrers are more mixed in their relationship with you. They may not refer out all endodontic treatment, or when they refer it might not be to you as their first choice. You might be one of several endodontists and they “share the love” with everyone.

There are strategies you can implement to improve those relationships, but the effectiveness of those strategies depends on certain fundamentals in your marketing system being in place, and your marketing coordinator executing those fundamentals with disciplined regularity. Their role to drive the marketing systems is vital. Here’s the marketing foundation. It’s quite simple, and yet many endodontists do not do this:

  • Every “A” referrer (12 or more cases per year) needs to be contacted once per month.
  • Every “B” referrer (5 to 11 cases per year) needs to be contacted once per quarter.
  • Every “C” referrer (1 to 4 cases per year) needs to be contacted once per year.

What happens in these contacts? The marketing coordinator drops by the referring office and delivers a little gift basket, bagel drop, seasonal goodie, or something that tells the practice they are important to you. These do not need to be expensive, and they should focus should be on creating delight. We frequently have marketing ideas for these contacts in this newsletter.

Your marketing coordinator becomes the face of your practice to the referring office and drives the team-to-team relationship. When they see the marketing coordinator coming through their door, there is recognition, familiarity and a sense of happiness. That is the beginning to top of mind awareness … in the team, in the doctor and eventually in their referrals.

With this system in place, then you have the foundation to really become effective and targeted in your marketing. For example, if a “C” referrer sends two cases in the same month (when they normally send 4 or less all year), then you can respond and connect in better ways. You can have a doctor-to-doctor phone call, or a scheduled lunch. The marketing coordinator can respond right away with another contact and gift that communicates how much you appreciate their referrals.

It all starts with the marketing coordinator who has flexibility as needed to be outside the practice and visiting referrers. Usually, it’s the equivalent of a day or two per week for preparation and drop in visits. Without a marketing coordinator, a system like this is rarely implemented with the consistency needed, and that creates barriers to growing referral relationships.

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