Endo Mastery


Cancellations and no shows are on the rise. It’s not just endo. It’s happening everywhere appointments are made or reservations are taken. Now is a good time to review with your team why appointments get broken and how to respond to patients.


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.

Join Us

Sign up to receive helpful practice management tips, debt elimination ideas, how to re-energizing your team, and much more.