Dental Cancellations Are Contagious: How one bad habit can infect your whole practice

Look, I get it. No shows and last minute cancellations, they're frustrating, they cost you money, and they also throw your entire day off. So the big question is, do you charge a cancellation fee? Some dentists say absolutely. Others worry that it's going to end up driving patients away. But what if there's a smarter, more strategic way to approach the whole thing? Today, we're unpacking what cancellation fees really do for your schedule, your culture, and for your bottom line. Welcome to the Next Level Practice podcast. I'm Kelly Damer, and in today's episode, we're getting into a surprisingly hot topic. Cancellation fees. Let's face it, missed appointments are more than just a nuisance, they're a signal. And how you respond can either protect your time or undermine your brand. This isn't just about charging a fee. It's about setting boundaries, reinforcing trust, and creating a practice that runs with intention. Here's what we're going to be covering on today's episode. The true cost of no shows. And guess what? It's more than just money. When a cancellation fee helps and when it hurts. How much to charge and how to communicate it. What to do instead if you don't want to charge a fee, and real stories from practices and what worked for them. So let's dive into the hidden cost of no shows because, and I guess this isn't probably surprising for you, but every open chair is lost production, lost opportunity and team stress. Especially if you have a structure in place with daily goals, daily production goals by provider and your team's being compensated for it. That's going to be a big stress maker for your team. But even more dangerous, it teaches your patients how seriously or not you treat your time. So do cancellation fees actually work? Yes, when they're used wisely, they set a professional tone and they do create a appropriate boundary. However, context really matters here, right? Is this just something that we're putting in place for new patients? Is it for established patients? Is it for first offense? Or is it just for those repeat offenders who keep showing up late or canceling last minute? The main thing that you really need to get out of this episode is that cancellations in general are symptoms of problems, not true problems themselves. The true problem that you really need to look at is that of patients not valuing your time. And that's not the patient's fault. I want to first and foremost say that it really comes down to the practice having good practices in place for patient experience. Experience value proposition during the the patient visit. And we're going to get into that a little bit more, but I want to really hone in on that. Cancellations and cancellations fees would be a solution to a symptom of a problem, not the problem itself. Now, the example I'm going to give you later, it's something where maybe when they're both used appropriately together, you could have a really great success rate. But if you're not first fixing the problem of patients valuing the time of the practice, the cancellation fee is just going to be a band aid on a sinking ship. Let's call it that. Okay, so how much should you charge if you're going to implement a cancellation fee? The sweet spot is typically around $50, depending on your fee schedule. But it's not about recouping the full visit cost. Okay. I want to make sure that's clear. It's truly just a message. Okay. This is something about signaling the value of your practice. Now, the next thing to make sure you're really keeping in mind is there's a right way to roll out this new policy. Right. It's not something that we want to surprise people with. We want to make sure they're prepared. They clearly understand this. So communicate early, clearly, kindly. There are specific scripts that we recommend that you use, and if you're looking for those, let me know. We can get you those scripts on how to communicate that new policy in place. Use intake forms, verbal reminders, and signage even as well. And it could be something like, listen, we understand life happens. Please provide at least 24 hours notice to avoid a $50 cancellation fee. Your time and hours is valuable. Another way of doing it is like, we have this time specifically reserved for you. And when you're not able to make it, you know, that's taking a spot that someone else could have taken. So please provide at least 48 hours notice to avoid a $75 cancellation fee. Right. Your time and hours is valuable. Now, if you are like, okay, all of this makes complete sense. Yeah, we've tried this cancellation fee. We've noticed we've had a. An uptick in patient attrition could be because of that. It could be something else. And you're like, I really need to focus on value proposition. Congratulations for hearing my message first and foremost. But let's talk about some alternatives to charging a cancellation fee. The first and foremost, again, is really focus on value creation during your patient visit so that this is just a no misappointment. What that looks like is a really great patient experience for new patients. Maybe you're doing a new patient patient office tour, which is really great. Introducing of the people along the way, making sure that you're doing that five time trust transfer, making sure that you are using a tangible standard of care, patient education tool, personal motivators, removing money as a barrier. All of those things are going to really lead to your patients valuing like wow, this place is different. I haven't been to an office like this before. You know, they really know what they're doing. They're a well oiled machine. I really understand exactly what's happening with my care. That's what's going through the patient's mind. And guess what? When they get that reminder to come to your practice for their six month checkup, it's like that is a no misappointment. They should not be missing that appointment. Some other things to do instead of charging, if you do still have some cancellations happening and you need to get like some quick fixes in place, create a VIP list for short notice openings. You should always have that so that you can send out, you know, maybe there's some text reminders that there's a last minute opening to fill that spot and make sure you're not losing production time. You know, you can use technology to send reminders and confirm appointments automatically too. Maybe it's something as simple as appoint patients knowing when their appointment's going to be. Consider a one strike policy and grace for first time offenders fee for repeat offenders. That's something really important to consider as well. So again, more than anything, focus on creating that value during the patient visit so that you're fixing the root problem here instead of just the symptom. So the doctor who comes to mind to me about this because we have some really great data points around it, is Dr. P. And she was losing 10 to 12 visits a week due to no shows. Okay. And after honing in on the patient experience through team education, again, what I was mentioning, personal motivators, patient handoffs. She saw her cancellation and no show rate drop into a healthy range of 7%. You should be keeping cancellations and no shows combined less than 10%. So that was super exciting. It's like, okay, great, obviously there's still a gap there, right? So she decided to implement a $75 fee with clear communication. She rolled it out appropriately and a compassionate tone specifically for the repeat offenders. And no shows actually dropped to 5% in 60 days and patient satisfaction and reviews actually went up. Dr. P actually said to me it wasn't about the fee, it was about the respect and value. And she said once that they saw that we, the practice, the team actually valued their time. So did they. So that's another really interesting take. You know, the patients are sensing if things are chaotic, you're not running on time, all of that. It's like, why should they value your time? So it was an interesting take that she really had. This is less about policy and more about value. You teach people how to treat you and your time. Boundaries are kind, clarity is kind, and consistent systems build trust. And guess what? It starts with you and your team. If you're. If you, the doctor is. Are consistently showing up late to huddle. If you're consistently showing up late to hygiene checks, then you're setting the tone for how time is valued. And I wouldn't be surprised if your cancellations and no shows are up higher than 10%. Okay, so let's recap what we learned today. Cancellation fees can be effective, but only with clarity and care. It's not about punishment. It's about protecting your practice and your brand. The real win is building a system where patients show up because they respect and value your time. If you're looking for help to build these policies that protect your peace and your profitability, book a free strategy session with me. We'll review your current systems, spot the gaps, and build a plan that supports your vision without the drama. I'm Kelly Damer, and this is the Next Level Practice podcast. Thanks for listening, and remember, every clear policy is one step closer to a practice that runs itself. Sam.