So, you had a no-show (or multiple) from your Facebook ads.

No-shows are a multi faceted and nuanced topic. While they may seem out of your control, there are several things your office can do to decrease no shows.

In this article, we'll discuss the primary reasons why patients no-show in the first place, and list potential fixes for each in turn.

It may surprise you that the biggest reason for no-shows is not forgetfulness, or because of competing priorities. In a study published by The Annals of Family Medicine, the following three reasons were cited as the top reasons for no-shows in a group of 32 women and 2 men in a healthcare setting:

1. Emotional Barriers (65% Mentioned)

This means that the negative emotions associated with getting a free consult at your practice outweighed the potential positive outcome of keeping the appointment. Emotional Barriers may vary, including but not limited to:

Problem: Fear

Fear of being sold treatment they can't afford, fear of an unknown and complicated diagnosis, fear of a dishonest doctor, fear of bad news.

Solutions:

• Phone Scripts - Adzenyth uses a carefully thought out, consultant-forged phone script to speak with patients prior to placing them on your schedule. In the script, we cover all the important details about the consultation to make the patient feel at ease.

• Website Information - If your website does not address patient fears, you may experience high no-show rates. Consider updating your FAQ page(s) to include answers to the above fears.

• Fix Online Reviews - A low star rating on Google or Yelp can increase no-shows. Adzenyth can help you run a Google reviews campaign to increase your online reputation, simply email info@adzenyth.com to get started.

• Post Photos to Your Online Listing - Post photos on your Google Maps, Yelp or other online listing.

• Post a 360 Degree Tour to Google Maps - Visit https://www.google.com/streetview/business/ to learn more about how to get yours updated. Other listings may have similar services, or you may be able to use the same video for all your online listings.

• Post Great Content on Social Media - Use your social media profile to engender trust, and showcase how great your practice is.

• Custom Trust Building Doctor Video - Adzenyth can send a video of your doctor or team member showing new patients around the office, and calming common fears to patients as part of their reminder sequence. Send your video to info@adzenyth.com and request it be added to your reminder sequence to get started.

Problem: Self-Resolving Symptoms/Desire for Treatment or Lapse of Discretionary Spending Money

While crooked teeth may not fix themselves between the time of scheduling and attending an orthodontic appointment, the desire to fix them may wane - as well as the ability to afford them.

Solution:

• Get the patient in quickly - Lori William, a respected and seasoned orthodontic practice consultant often comments, "Patients only have so much money for a down payment. If you don't get them in quickly, they'll spend it on something else." While many orthodontists pride themselves on being booked out for weeks, patients (especially those who haven't been referred to your practice) prefer to get in for a consultation as soon as possible - if you want to grow your practice (and avoid no-shows), you must focus on seeing new patient consultations quickly - ideally within 3 days.

Problem: General Negative Feelings Toward Healthcare

While an Orthodontic consultation is different from a typical medical appointment, some patients may view them in the same way.

Solutions:

See solutions under "Problem: Fear" section.

2. Perceived Disrespect of Patient's Beliefs and Time From the Healthcare System (44% Mentioned)

There are three primary ways patients cite feeling disrespected from the healthcare system:

Problem: Waiting

Whether waiting to be scheduled, waiting for their appointment day to arrive, or waiting in the waiting room - patients don't like it, and feel disrespected when it happens.

Solutions:

• "Speed to Lead" - The Adzenyth appointment scheduling team strives to contact every lead as soon as possible.

• Get the Patient in Quickly - See solution under "Self-Resolving Symptoms..." above

• Provide a streamlined consultation experience - If you respect your patient's time, your patients will respect you and your time more. Consider implementing 30-45 minute consultations for this reason.

Problem: Lack of Understanding/Empathy Around Treatment History

Patients want to make sure their case is understood, and that the underlying issue is permanently fixed, not just temporarily relieved.

Solutions:

• Call Scripts - The Adzenyth team asks leads on calls why they are looking into treatment, and if they have ever had treatment before. This often opens up dialogue that helps the patient feel valued and understood.

• Consult Trust Building and Listening - When presenting treatment plans and fees to patients, ensure they feel listened to, and feel that they are getting a customized plan.

Problem: Lack of Respect for Opinions

Empathizing with the opinion and experiences of patients is crucial to getting the patient to show and close.

Solutions:

See solutions under "Problem: Lack of Understanding/Empathy Around Treatment History"

3. Lack of Understanding of the Scheduling System (41% Mentioned)

A direct quote from the "Why We Don't Come: Patients Perceptions and No-Shows" illustrates this problem well:

"Forty-one percent of the participants indicated they did not know what happens in a clinic if there is a failed appointment. Ms. S speculated, “Maybe they just go to the next patient.” Participants seemed unaware of the financial impact of a failed appointment and believed a no-show may actually be a positive event for the clinician and staff. When asked what the staff and clinician do if someone does not show for a scheduled appointment, Ms. H stated: “I don’t know. I guess they get free time.” Similarly, Ms. B said: “You know what, I don’t know. I know that if it’s a crowded day, they’re probably very happy."

Solution:

• Call Scripts - The Adzenyth team incorporates this line at the end of every call: "I have you confirmed for [Day] at [Time] my name is Ashley and this is my personal line - if anything comes up can you please reach out to me and let me know so we can provide this appointment to someone else?" This impresses the importance of notifying the office if the patient can't make the appointment.• Get the Patient in Quickly - The faster you can get a patient in, the more they will respect your business and the less likely they are to no-show.

No-Show Elimination Checklist

Refer to this checklist to ensure you've done everything in your power to reduce the amount of no-shows your practice receives:

• If my team communicates with the Adzenyth leads before they come in, are they actively working to engender trust and calm the patients' potential fears?

• Does my website include FAQ's or information about orthodontic consultations that addresses potential patient fears?

• Does my Google Maps listing have a 4.5+ star review rating with 50+ reviews?

• Have I responded to all negative reviews on my Google Maps listing?

• Have I posted photos of my practice from the outside and inside to my Google Maps and other online listings?

• Do my Facebook and Instagram profiles have recent pictures that showcase how great my practice is?

• Have I sent an office tour video to info@adzenyth.com to add to my patient reminder sequences to help establish trust with new patients?

• Is my team able to schedule the leads that come through Facebook within 3 days?

• Do I actively work on listening to patients when they come in for a consult? Do my potential patients feel understood, valued, and heard?

• Is there anything else in my online or local reputation that could be affecting show rates? What can I do about them?

• Is there anything about the location, naming, or appearance of my practice that could be affecting show rates?

What if Patients Still No-Show?

Even after completing all of the above items, you may not be completely happy with your no-show rate. Social Media leads usually are, by nature, less likely to show up - this will require you to change your systems in order to grow your practice.

Once you have done everything in your power to lower the no-show rate, other courses of action can help you mitigate the time lost to your company:

Double or Triple Book Consultations

Some of our most successful Adzenyth doctors triple book their appointments. This ensures no time is wasted. Dr. Tyler Coles of Premier Orthodontics has calculated his show rate from Social Media leads at 45%, and therefore double books every spot if the lead is generated through social media. If both patients show up, his staff is trained to do the typical consultation in a different order, or the patient is asked to wait in the entertainment lounge.

How on Earth Do I Deal with Double or Triple Booked Consultations?!

The first step in this process is shortening appointment times. The idea that orthodontic consultations need to be one hour long is a fallacy. Many doctors hold 30 to 45 minute consults and find their conversion rates are higher than ever. It's also easier for patients to fit shorter appointments into their day, so these are easier to schedule as well.

The only three things patients need to know to make a purchase decision are:

• Length of Treatment

• Type of Treatment

• Cost of Treatment

While the order of events in your consultation may vary, here is an example of a 30 minute consultation order of events:

9:00- Front Desk Greeting

9:01 - If no insurance info yet, immediately pass info to insurance coordinator

9:02- Treatment Coordinator brings patient back and gets to know them

9:04 - Treatment Coordinator takes X-Ray

9:08 - Treatment Coordinator sits patient in consultation room, puts the pano on the screen

9:10 - Doctor walks in, Treatment Coordinator introduces patients and doctor

9:11 - Doctor picks up the conversation and answers:

• Estimated Treatment Length

• Recommended Type of treatment

• Appointment frequency

9:16 - Doctor passes financial conversation to Treatment Coordinator

9:16 - 9:30 - Treatment Coordinator closes the patient

While in the process of shortening your consultation times, track your show rate on leads from social media. More than likely, you'll find that double booking does not expose you much risk. If you find that show rates are particularly low, or think you can handle triple booked appointments, try that out!

Keep in mind that all of the advice in this article is a process! Just do your best to start moving in the right direction, and you will be surprised by the difference small tweaks in your process can make.

Here is a quote from Dr. Mohammed Mahdi, who has achieved success in conducting 30 minute appointments:

"With 30 minute consultation[s] it gives me and my treatment coordinator enough time to check the patient, go through insurance and payment plans. It also allows offices to see more consults and generate more income. I personally don’t see any need to extend consultation appointments beyond 30 minutes."