Sheri's Solutions: The 8 o'clock patient

By Sheri Doniger, DDS, DrBicuspid.com contributing writer

July 16, 2013 -- It is 8 a.m. on a typical weekday. You have been in the office since 7:15, checking charts, having your team meeting, getting your "game" day planned. So where is your confirmed 8:00 patient?

Sheri B. Doniger, DDS
Sheri B. Doniger, DDS.

The minutes tick by without a word. Now it is 8:15. You recheck the voice messages to see if you missed a request for a change of appointment. Now it is 8:20. Out of concern and courtesy, you call the patient to see if anything happened, are they on the way? After all, you had no phone call, email, or text saying that this patient would be late or had canceled.

Finally, you reach the patient, who tells you he is almost there and will be in the office momentarily. "Momentarily" turns out to be 10 minutes. Finally, at 8:35, he shows up.

What to do? Do you alter your entire day's schedule to treat him or reschedule? It completely depends on the practice's philosophy as well as available chair time. Normally, with patients arriving more than 15 minutes past their scheduled time, the office may not have time to fit them into the day without inconveniencing the rest of the confirmed patients. It may also be the philosophy of the practice to reschedule patients if they show up later than 10 minutes past their scheduled time.

In this day and age, with schedules less than full in many practices, late patients are usually accommodated. Even practices with full schedules will treat the patient if they feel the excuse is valid. Rather than being an arbiter of excuses, if we have time to see the patient, we will.

This happened to our office last Thursday. Our 8:00 patient, confirmed at least twice (he missed his appointment last week -- overslept), did not show up on time. We called and he wasn't in an accident but obviously time-challenged and delayed for whatever reason. Our first response was to tell him to come in. We erroneously thought he was in the parking lot, and while he must have been within the village limits he was not truly that close. We called our next patient and notified him we were going to be approximately 20 minutes late for his appointment and could he please come in later.

When our 8:00 patient finally arrived -- at 8:35 -- he was overly apologetic. He said that 8:00 obviously does not work for him anymore and would we be able to schedule him later, at 9:00. We did treat him that day, scheduled him for a later appointment the following week, and were very late for our next patient (who did not receive our message because he hadn't turned on his phone). As you can imagine, the rest of our day was off by a minimum of 20 minutes.

Normally, I do not like to treat late patients. This was an exception for this particular patient at this particular time. The gentleman had recently decided to rejoin the dental world after a long hiatus. He does show up (albeit occasionally late) and does pay his bills at the time of the appointment. In fact, he is a dental convert: He bought a Sonicare as well as an AirFloss and is attempting to maintain his dentition and keep up with his oral health. To turn these particular patients away would not have been wise. It is not the same with every patient.

Rendering care to late patients is a slippery slope. If you treat someone who is perpetually late, it only reinforces that our schedule is not that important (or as important as theirs). Rescheduling patients who are late does give a message that our time is important, as is the time of the next patient, and the one after that, and so on. It is a judgment call, usually made by the business manager at the front desk with regard to office policy.

This particular patient apologized profusely to the patient in the reception room as he was leaving. My next patient understood and had some time to spare. Others may have not. As a practice policy, we do not normally see patients later than 10 minutes past their scheduled time. Accommodating a late patient is not something we are always comfortable doing, but as it turned out the day went well and was highly productive -- not always monetarily but with good will.

So next week, when we have this particular patient scheduled for 9:00, we shall see if he makes it on time. If not, we may not be so lenient in the future.

Sheri B. Doniger, DDS, practices clinical dentistry in Lincolnwood, IL. She has served as an educator in several dental and dental hygiene programs, has been a consultant for a major dental benefits company, and has written for several dental publications. Most recently, she was the editor of Woman Dentist Journal and Woman Dentist eJournal. You can reach her at donigerdental@aol.com.


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