2 Plugging the Holes
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Dynamic Chiropractic – March 25, 2002, Vol. 20, Issue 07

Plugging the Holes

By Rose Jacobs, CA
CAs, can we talk? Do you ever review the upcoming week's appointment schedule and wonder, "Where are all of the patients who had appointments a couple of weeks ago?" Shouldn't the appointment schedule be as full as it was back then? New patients are coming in the front door, but somehow they must be escaping out the back. I know - your patients are being abducted by aliens that will not allow them to return for their chiropractic appointments - right? (Okay, that was a bad joke!)

If this scenario sounds familiar, I am here to assist you in plugging those escape routes or holes. The plugs are procedures and systems you should implement as soon as possible, before it's too late. Keep in mind, it is easier and less expensive to plug the holes of a sinking ship (the clinic) and start bailing, than to raise it from the ocean and make repairs before you can resume sailing!

First, preschedule patient appointments. It is a written policy in our clinic that all active care patients must preschedule a group of appointments with the doctor. This is at least a minimum of 12 visits through the first or next re-exam date the doctor recommends. This system has many advantages for your patients and the front-desk CA, such as improved time management, but it also shows the patient's commitment to the doctor's care plan. It also assists the CA, who doesn't have to "catch" patients to schedule the next visit before they fly out the door.

Second, each patient should have a prearranged financial commitment to the clinic. Your clinic is not a loaning institution. Do not allow patients to charge their services, except, of course, to their major credit cards. People that owe your clinic money begin to avoid you. You are doing a disservice to your patients if you allow them to owe money. These individuals will most likely discontinue the care they need, and will not reschedule their appointments. Patients that pay, stay.

Third, when patients are more than 10 minutes late, assume that they are not coming, and call them. The appointment may have been forgotten; maybe the patient could not get out of an important meeting, or had a family emergency, or didn't feel like driving to your clinic today, and did not have the courtesy to call. Whatever the excuse or situation, it is up to the front-desk CA to get the patient in the door to make up the appointment ASAP. If at all possible, reschedule a makeup appointment for later that day, or the next business day. Do not wait to call the patient that night, or in a couple of days. Call the patient now, and get him or her in!

Fourth, have a rescheduling system in place. If the front-desk CA was unable to contact the patient directly after the "no-show" appointment, and was also unsuccessful reaching the person prior to leaving the clinic at the end of the day, the patient's name should be added to the clinic's rescheduling system. This system will now track when and how the CA attempted to contact and reschedule the patient. I recommend that only one member of the CA team be responsible for managing this system. If at all possible, the front-desk CA should not be that person.

Fifth, if the patient cannot be rescheduled, for whatever reason, the CA needs to communicate this to the doctor. Doctors need to know what has happened to their patients to decide how to handle a "dropout." I recommend that a letter be sent to the patient, signed personally by the doctor, expressing concern over the patient's absence, or the doctor may want to call the individual later in the evening at home.

Caring is a big business advantage. Show your patients how much you care by getting them to your clinic. Doctors cannot help people with their health if they miss appointments or discontinue care.

CAs, until next time, go out and make a difference!

Rose Jacobs
Chesterfield, Missouri

Click here for previous articles by Rose Jacobs, CA.

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