'The problem has reached a critical mass': How patient cancellations are affecting dentists

Patient cancellations continue to be a major problem affecting dental practices in the U.S., preventing them from filling their schedules and leading to revenue losses. 

According to the American Dental Association's Health Policy Institute, patient cancellations were the main factor preventing practices from filling their schedules these last few months. 

In June, 82 percent of dental practices stated patient cancellations affected their practice schedules, followed by a lack of appointments being made and staff shortages.

Here, four dentists shared with Becker's how patient cancellations are affecting their practice:

Editor's note: Responses were lightly edited for clarity and length.

Robert Trager, DDS. Dentist at JFK and LaGuardia airports (New York City): Since my office is physically in the JFK and LGA airports, I have always experienced cancellations. Now more than ever, with many airline cancellations and delays, I have seen an exacerbation of this situation. Knowing this has always been a problem, I try to overbook and/or have a list of patients who are within 15 minutes of getting to my office because they are in the same workplace. Many other dentists around the country are experiencing the same problem even though many of their patients have been vaccinated. I believe the reason for so many cancellations is that every month a new variant of COVID-19 arises, thereby causing many patients to have trepidation and to be fearful of the unknown effects of the new variants. Also many patients may have lost their insurance and can't afford out-of-pocket expenses and copayments. A resolution for this problem may be for dentists to educate their patients that their office follows all infection control protocols and for patients as well as the dental office to text each other in advance to change appointments. My best advice is to open your office right in or near the workplace where many of your patients are situated.

Lan Allen, DMD. Aeris Dental (Tuscon, Ariz.): We don't have them because we stopped scheduling six-month recall appointments. We only open our schedule four weeks in advance.  Patients have had a hard time adjusting because of tradition, but we don't have the problems we used to. The industry is experiencing this because we have been unable to grasp the reality that we are not a planning-six-months-ahead society anymore. We are in a live-today society.  Order food we want from anywhere and get it in an hour. Amazon Prime same day. We can't expect people to realistically keep a six-month appointment anymore, and if we schedule them, we are counting on less employees to do more work rescheduling them. It just doesn't make sense anymore to do it. We went from 25 to 33 percent cancellation and no-shows to less than 10 percent.

Luke Morgan, DDS. Luke Morgan, D.D.S. & Associates (Mechanicsville, Md.): Currently we are fortunate to be booked three-plus weeks out. My front office states there are occasional cancellations mostly due to work or illness, but they are able to fill the openings quickly with patients wanting to be called for earlier appointments. 

Training the front desk to mitigate openings and fill them quickly is very helpful. Occasional no-shows do occur and we try to be productive with other tasks or offering same-day treatment to patients in the office for hygiene and recare appointments. 

I think this is common among many dental offices, and communication on how to fill the cancellations with staff is paramount. Text messaging and also a call from an actual staff member will help to prevent no-shows and address any changes the patient might have before their appointment time. 

Mark Malterud, DDS. The Minnesota Center for Minimally Invasive Dentistry (St. Paul): We are having an increase in patient cancellations, and it is putting a stress on our team to fill the schedule. We are currently understaffed in the area of hygiene so this is an added stressor, but we are actually lucky in that we have a waiting list of people who want to get in for their hygiene treatment to fill the gaps that are created. 

That being said, I think the problem has reached a critical mass. I believe that we have multiple behavior issues going on here. First of all, the COVID-19 shut down has created a segment of the population that is fearful of coming in, and we need to address that with communication and showing them the care we take to keep the office free and clear of any forms of diseases.  Secondly, and this is a greater issue, the mindset of the patients has changed during COVID in that it is so easy to use the COVID fear to back out of an appointment if something comes up.  We generally don't question them on any cancellation due to COVID exposure or infection. Probably the best way to address this is to educate our patients on the importance of the oral systemic connection and that dental hygiene is a strong strategy to increase your health and prevent infections. The research is strong that the viral load of COVID is high in the oral and pharyngeal areas and guess what, that is right up dentistry's alley. Yet, transmission within the dental office is low, and that should be a testimonial of the safety precautions we are taking to protect our patients.

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