The Confirmation Blues

Do you have the confirmation blues? Do you remind your patients about their scheduled appointments over and over again, through multiple channels, only to have them no-show anyway? Do patients complain that they forgot their appointments because your office didn’t send them yet another text or email? Is your front desk team overwhelmed with monitoring whether patients have “confirmed” their confirmed appointments? Would you like an alternative to this craziness?

Whose Appointment is This?

It would be tempting to blame patients for this situation. After all, if they could just be more responsible for their appointments, you wouldn’t need to spend hours and hours chasing them. But, let’s look at your contribution to this. While I’m not a raving fan of Dr Phil, he does say one thing I find instructive.

We teach people how to treat us

If we apply this statement to our behavior with patients, then we can see that the constant messages reminding patients about their appointments actually communicates that we don’t expect them to honor their commitments, that your office takes more responsibility for these appointments than they do and that we are essentially begging them to come in.  We do all this because we believe that if we didn’t, an even greater number of patients would miss their appointments.  Maybe. But could it also be true that you have trained your patients to be irresponsible?

The Message in your Messages

In my role as a consultant, I review the text/email messages that dental teams send to their patients and I have found that most of them only inflame the problem. Here is the message my own dentist (who I adore) sends me after I leave his office. I am told to click on one of the following choices:

• Yes, I have no conflicts with this time.
• I can’t make this time. Call me.

Now what the heck does the first statement even mean? It hurts my English-major heart to read this confusing negative/positive statement. And the second choice doesn’t work either. I JUST left their office, if I discover that I now can’t make the appointment, it should be my responsibility to call them – not the other way around.

Here is what the message could say:

Your next hygiene appointment is reserved for XX date. Please put this date in your calendar.  If you need to reschedule, call now.  If a scheduling emergency arises, we require 2 business days’ notice.

Why is this a better message? First, it doesn’t require the patient to confirm an appointment which was just made and confirmed 15 minutes ago. Instead, the message advises the patient to take an action to “remember” their own appointment, because it is THEIR responsibility. And finally, the message alerts the patients about the practice’s scheduling guidelines.

Here is an example of another terrible text message that was created by a third-party patient connection company (I won’t name them for my own protection!)

Hello John, this is L Dental Care. Success! Your appointment has been confirmed on June 22, at 2:17 pm.  If insured, have we received your current dental insurance information?

These are the reasons I dislike this message:

1. Telling a patient their appointment is NOW confirmed is misleading. The appointment was already reserved and confirmed when the patient made it.  How many times does a patient need to confirm? Frankly, it’s language like this that leads patients to think that they don’t need to commit to an appointment time since there are so many opportunities for them to confirm and re-confirm they are coming.
2. The question about insurance is bizarre on many levels. First, this is phrased as a close-ended question that doesn’t direct the patient to do anything except answer the question for themselves. So, the patient might wonder if the practice has their latest insurance info –and conclude this can wait until they get to your office to find out.
3. If the one question you ask patients is about their insurance, then you are underscoring that your practice has an insurance mindset. And what does this question imply for your patients who don’t have insurance?

Here is a better message that requests the patient to provide information that will actually help the appointment.

Hello John. We’re looking forward to seeing you on June 22^nd for your hygiene appointment. So that your appointment can start on time, please let us know by June 18^th if there have been any changes with your health, insurance benefits or if are taking any new prescribed or over-the -counter medicine.

Benefits of this message:

• The message doesn’t use the terms “confirm” or “remind” because the appointment has already been confirmed and the assumption is that the patient is coming.

• The message identifies the purpose of the visit as a “hygiene” appointment – which is an upgrade from the term “cleaning.” Your office can personalize this even more by naming the hygienist they will see.

• The message describes a benefit to the patient: your appointment can start on time if you respond to the question. There is even a specific date by which the patient needs to respond.

• The patient is asked health related questions that can help their clinician. How many of your patients know they are taking some new blue pill, but can’t remember the name or dosage?  Or your patient is taking aspirin but doesn’t mention it because they see as an over-the-counter drug that has no bearing on their dental work. Wouldn’t it be better for your office to have a heads up about these changes, BEFORE the patient arrives?

• The insurance question is folded into the larger issue of medical changes. It’s not emphasized as the only thing you want to know about the patient.

The Confirmation Call

If your practice must call patients to ensure they are coming, use the same language as the text message. You aren’t calling to confirm or remind the patient; your office is calling to see if there have been any health changes since the last visit. If the visit is for restorative care, then the call is to see if the patient has any questions about the procedure. The assumption is always, the appointment is already confirmed and the patient is committed.

Final Insight

These language changes are important because language both reflects and shapes our behavior.  We must do a better job in changing the locus of responsibility from the practice to the patient. This is the first step in reducing no-shows and creating a true partnership with patients.