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Cancellations/ no shows

Discussion in 'Australia' started by Kara47, Sep 17, 2013.

  1. Kara47

    Kara47 Active Member

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    Hello All,
    How many of you have a policy in place or charge a fee for those repeat offenders who make appointments & don't turn up, or cancel at the 11th hour so they can see the hairdresser/ go on a bus trip/ play bingo?
    Interested to hear what works, how you notify patients & what the general reaction is.
  2. retropod

    retropod Member

    Over the years my DNA/late cancellation rate has run at about 8%.
    As a result, we have tried many things to counteract this.
    Phone call the day before...time consuming, no change in %
    Make it hard to get another appointment.....helped a little
    Charge 30% of the normal fee......can create alienation..but then they go away...never to DNA again.
    Charge a bunch of flowers from their garden....makes a friendly point.
    Spend more time negotiating their appointment time that really suits them....rather than the "take it or leave it" method..........this has been the most effective.
    And......accept that human beings are the centre of their own universe....and that your being inconvenienced is of no consequence to them
  3. podesh

    podesh Active Member

    Hi Kara

    Had to laugh....sarcastically! reading this whilst I have a break, my second no show of the day. Both with reminder calls! So annoying as I have massive list of people on my cancellation list.

    I think I will have to start charging and have a two DNA's and you're out policy, obviously with exceptions, as sometimes things do crop up.

    Have a good day

  4. Craig Payne

    Craig Payne Moderator

    My understanding is that you can only enforce payment for if they knew in advance that they would be charged if the failed to attend.

    You can always send them an invoice and they may pay; but if they refuse and you can not show that they were informed in advance that they will be charged, then you have no case.

    There was this previous thread:
    Payments for no shows
  5. Kara47

    Kara47 Active Member

    Thanks all,
    Retropod, you summed it up very accurately with your last sentence!
    I checked the calendar & it is full moon this week ( explains a lot!)
    Cheers Esher, catch up soon :)
  6. trevor

    trevor Active Member

    I would have to agree with everyone and do not have the answer either.
    However the full moon theory is the best reason that I have seen and may have some merit.
    Several years ago you would have had to explain to us what a DNA was, we just did not have them.
    Today it is a totally different story.
    Now on the bottom of our appointment cards, just below the next appointment space it reads:-
    "MISSED APPOINTMENTS: Unless notice of at least one clear working day is given to cancel an appointment, a fee will be charged."

    We have a similar statement on patient receipts.
    We send SMS reminders to all patients with a mobile, a practice management software function,and phone the rest.
    This still does not always work. we still get no shows, there were two in one morning last week.

    Just remember that the next time you see a DNA patient you are effectively giving them a 50% discount.

    When a DNA patient phones for another appointment they are advised the cost of the DNA fee and that it has to be paid at their next appointment. (there are exceptions) Patients can then chose to make their next appointment or not.
  7. Mr C.W.Kerans

    Mr C.W.Kerans Active Member

    There is no right in handling no shows/late shows - its up to each practitioner what to do. Here in Ireland in the public health system, Out-patient appointments are 20% DNA's, but the system has a waiting room full of patients - they are "banked" - so the clinician's time is not wasted. I work by appointment - if you have an appointment with me, I see you at the time given - this means the patient is not kept waiting, but if they do not attend for their appointment, there is nobody to take their place. I consider each case on its merit - forgotten appointment, short notice cancellation(<12 hours) or whatever is discourteous, wasteful of time and carries a financial penalty. I also resent having such rude people make me consider changing my established practice to "banking" patients as most medical and dental colleagues do in their practices. Seeking a fee to cover DNA's is not actually getting the fee.
  8. Patrickg

    Patrickg Member

    at our practice we have a cancellation fee of 33%, this is only for repeat offenders who have no real excuse. I think we have implemented it only three times this year, most patients have a good excuse or its a complete one off. I think the best thing is to just sit down and talk with the offender and explain why its important to book in advance on a day when they KNOW they can make it, as it means that someone else who could have had the spot misses out.
  9. Kara47

    Kara47 Active Member

    Thanks all for your input.
    We have recently put up a sign at our front desk stating the fee, and it has got at least one habitual offender to take notice ! ( Promised she will at least ring!)
    Is it just me or are people just becoming more selfish/ inconsiderate & rude by the week?
    Having said this, 95% of our patients are LOVELY, turn up early, consistently & are pleasant to deal with.
    (The ones who bring cake or flowers are ADORED!!)
    We seem to nearly always have a cancellation list of people waiting on appointments, so the no shows are doubly frustrating in that not only have we lost income, but someone who genuinely WANTs to be seen has to wait longer.:bang:
    I have long had a policy of 3 strikes & you're out ( 2 if you really p### me off), so I think I've been pretty tolerant up to now.
    I'll get off my soapbox now,
    over to you,
  10. toughspiders

    toughspiders Active Member

    Last year i put a sign up showing how many missed appointments there had been. Shocked the life out of some of them! Especially when i equated it to dollars!
  11. terigreen

    terigreen Active Member

    Call the patients the night before their appointment to remind them. Also, if a two month follow up, could also send a post card a week before. Good post, thanks

    Atlas Biomechanics
  12. Kara47

    Kara47 Active Member

    Hello Teri,
    That's the thing, we DO give reminder calls to all px the day before!
  13. terigreen

    terigreen Active Member

    That is why we double book. We also call the habitual offenders a hour before to remind them. If you are really busy drop them, if not deal.

    Atlas Biomechanics
  14. Kara47

    Kara47 Active Member

    So what do you do when 2 people turn up for the same appointment? Draw straws?
    I don't have habitual no shows any more, they get the flick if it happens twice with no valid excuse.
  15. Mr C.W.Kerans

    Mr C.W.Kerans Active Member

    There is no answer to this problem, at least that's the conclusion that I've come to after 25 years in practice.

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