CUSTOMER EXPERIENCE - Dealing with the Late Patient, Early Patient, & Walk-Ins

It’s so annoying!  We all work so hard to stay on schedule and we still have a group of patients putting us behind by chronically showed up late for their appointments or simply walking-in without an appointment.  When this does happens, often the patients who DO report on-time have to wait while we “work in” the late ones.

Not all orthodontic patients feel being on-time is important (or possibly less important than something else). In their own minds, there’s always a good reason.  But if we see them whenever they do walk in or are late, then they don’t suffer any consequences and they’re more likely to repeat the behavior in the future.

For any potential protocol, we want three things when it comes to this issue.  We want to:

1. Prioritize the appointment times of patients who do show up on-time.
2. Minimize the impact on the schedule for the rest of the day, and
3. Reduce the number of walk-ins and late arriving patients through scripting and some predetermined consequences.

As silly as it sounds, sometimes we have to TRAIN our patients to be on-time.  Here’s a “system” that seemed to improve the situation for us.

LATE PATIENTS

• If patient has missed approximately ½ of the appointment time, (usually 15 minutes)

1. The doctor will check patient, modify the procedure to stay on schedule (do the “rate limiting step” as discussed in the clinical seminars)
2. Most likely, the assistant will change A-chains & retie if necessary and reschedule
3. Usually, the patient is not informed of the modification of what was planned for the day so as to avoid any controversy with the parent.
4. If patient is late and they have a bracket off, we will inform the parent that “we don’t have enough time planned for that today, so we will make them comfortable & reschedule the appointment.”  Also, “Next time, if they will call us and let us know, we can alter the appointment time so that we can complete everything in one visit”.
5. For patients starting treatment who are late, we will only bond the upper arch after informing the parent.

• If patient has missed more than ½ time allotted or comes in AFTER their allotted appointment time:

1. The front desk says, “I’m so sorry, we were expecting you at <time>. The doctor can see you today to make <the patient> comfortable and check to see if everything is OK. Then we can reschedule you so we can keep you moving forward.”
2. The doctor MUST see them for a safety check.
3. The doctor checks the patient and reschedules appointment ASAP
4. A note will be made in the chart of the late arrival.

• When the patient calls and says they will be late, this is our response:

1. “Thank you for calling and letting us know you will be late. Will you be able to make it in the next 10 minutes? If not, it will be best to reschedule, so we can complete everything we have planned for this appointment.”
2. If they do come significantly later than expected, the doctor will check patient, modify the procedure to stay on schedule (do the “rate limiting step” as discussed in the clinical seminars)
3. If they reschedule the appointment, the front desk will make a note in the chart and notify the clinic.

WALK-INS

1. Front desk says, “The doctor will be willing to see you to make you comfortable and check to see if everything is OK. We will then reschedule you to complete the entire repair. You probably will have to wait more than 30 minutes.”
2. Also, the front desk says, “If you call us next time, we can give you a repair appointment and you won’t have to wait”.
3. All walk in patients will be held in the reception area for 30 mins even if there is a chair available. ( I know this may be controversial, but this is part of the “training”.)
4. If they are comfortable and don’t wish to wait 30 minutes or more, they can schedule a repair visit and have the entire repair completed then.

EARLY PATIENTS

1. The front desk says, “Oh, we expected you at <time>. If someone ahead of you cannot make it, we can send you back early.  Otherwise, we can definitely see you at your scheduled time”.
2. Early patients will wait in the reception room until their appointment time unless the patient due in front of them is at least 10 minutes late. In this case, they can be sent back early.

Unless we're willing to enforce some procedures for handling patients who don't arrive on time, chaos will often reign.  Take control of the schedule, always do it compassionately, but make a mutual agreement with patients -  if we stay on schedule, we're asking them to do the same.