Are You Giving Patients Permission to Cancel?
Several years ago, an experiment was performed in 10 daycare centers to try to find a way to deal with the problem of parents arriving late to pick up their children. It was decided that a fine would be introduced: For each incident, $3 would be added to the client’s monthly bill.
Within a few days it was obvious that the parents responded to the new rule. Now, instead of the average eight late pickups a week the daycare centers were dealing with before, they were up to about 20 a week. Clearly, the incentive had an effect, but in the wrong way.
The authors of the book Freakonomics, where this story comes from, explain what went wrong.
It substituted an economic incentive (the $3 penalty) for a moral incentive (the guilt that parents were supposed to feel when they came late). For just a few dollars each day, parents could buy off their guilt. Furthermore, the small size of the fine sent a signal to the parents that late pickups weren’t such a big problem. If the daycare center suffers only $3 worth of pain for each late pickup, why bother to cut short the tennis game?
And if your dental office tells you when you make the appointment to let them know if your plans change, why not let the hair appointment you want for tomorrow bump the dental appointment you made months ago? And if they’re calling to “confirm” that you will be coming on Thursday, that must mean it’s okay to say no at this point, right?
These are the subtle ways that dental offices unintentionally send a message to patients that appointments are flexible and less important than other obligations in their lives. Like the daycare owners, you’re sending a signal that it’s not a big problem—but it is.
I have always said that you should explain to each new patient right up front, that in your practice an appointment is a confirmation and that an operatory and the provider’s time is being reserved for them. That’s why you should make courtesy calls to remind them of their commitment, rather than calls to confirm what already was confirmed when they made the appointment. Otherwise, you’re giving them permission to “buy off” the guilt of cancelling.

