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  • Chris Ciardello

To Reject or Not to Reject?

Updated: Oct 29, 2021

Contacting patients to schedule them for their unscheduled treatment is one of the most important aspects of every dental office. When you have reached out to a patient and they give you excuse after excuse on why they are not ready to schedule or they just don’t answer the phone or call you back, what do you do? When do you “give up” calling them and what do you do with the work that is sitting in their treatment plan? These are questions we are faced with quite often, and different members of the same team will often have different views on how to handle these situations.

First we need to determine the practice philosophy in regards to when and how often are we contacting our patients when they leave the office without scheduling their next visit. At GTS, we believe that if a patient leaves the practice without scheduling their next visit on their treatment plan that we want to call the patient 3-4 days after their visit to follow up. At this point the treatment plan is still fresh in their mind, they’ve had sufficient time to discuss it with their spouse, as well as review their financial situation. If the patient does not answer or they tell you they still need time to discuss and review their situation, then reach back out to them 1-2 weeks later. We suggest continuing to reach out to them every couple of weeks. Every now and then you will get patients who continue to dodge your calls or give you excuse after excuse, which begs the question: when do you “give up” and stop calling them?

Personally, I only call on treatment plans that were diagnosed within the last 4 months. If after 4 months of trying to schedule the patient unsuccessfully, then for some reason the patient didn’t believe the treatment was necessary. If you call a patient that had a crown diagnosed over a year ago and you call them to try and schedule them for that crown, often times the patient will not remember that the treatment was diagnosed and may lose trust in your office because they may think you are trying to pull a fast one on them.

After 4 months, we suggest that you call the patient through your recare or hygiene list and get them back in for their cleaning so your hygienist can bring up their treatment again and reeducate them on the importance of completing their treatment plan. Often times, treatment has changed when they come in for their next six-month visit. If there were no changes to the plan, then reprint it and review the plan with them. Educate the patient on how the decay doesn’t get smaller and if it spreads too much you may not be able to save the tooth.

If their treatment plan has changed, we suggest rejecting the previous plan and entering a note stating that we reviewed this plan six months ago, however the patient did not want to schedule the treatment. Then reenter the changes to the treatment plan as well as all the treatment that was still the same. Review the treatment plan with them, emphasize the aspects of the plan that changed because they did not schedule the treatment when it was first diagnosed and stress the importance of completing the treatment so it does not get worse. This is a moment we want to review all clinical aspects of the treatment. Once they have been sufficiently educated clinically then we can start having the financial conversation.

There are other times that patients have treatment diagnosed years ago, they finally come back into the office and we need to inform them of their current dental state. Before entering any new treatment to their plan, reject everything in their old treatment plan. This will help to keep their chart clean, understandable and accurate. We never recommend deleting their old treatment plan in order to enter their new treatment plan. Deleting the treatment plan leaves you with no paper trail of their prior diagnosis and can put the office in an undesirable situation, in the event that a patient questions the previous diagnosis.

We often hear that patients will come in without ‘knowledge’ of treatment needed or claim that the office did not review a treatment plan with them. Thankfully, these offices have dated copies of these treatment plans in their computer that correspond with their previous visit. We even recommend that an office have the patient sign a copy of the treatment plan to dismiss any claims of failing to review treatment.

Periodically, we like to have a team member pull up patients that have really old treatment plans (typically older than 18 months) and reject the plans. We like teams to have a current and clean database to pull from when working their unscheduled treatment reports. Spend the time reviewing and cleaning up your treatment plans so that time is not wasted when trying to determine if the plan in front of you is worth researching and contacting the patient.

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