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  • Amie Spurlock

Overdue Recall - The Struggle is Real!

Does your team struggle with working your recall system? Your schedule is booked for at least six months and you have nowhere to put overdue patients. It is a problem, but you are not alone. We have solutions!

Demand is up, schedules are tight

The recall system is the lifeblood of the practice and promotes optimal patient health. Having a healthy mouth is vital for consistency in oral care, hygiene appointments, and treating conditions as early as possible. More often now, we have a full schedule that is booked out four months or more, which makes it difficult to get our patients back on the schedule. When our teams reach out to overdue patients, they are faced with obstacles that result in losing focus on this critical system.

From practice to practice, there are common themes, such as having nowhere to put patients to frustrated patients not able to be seen in a timely manner. We feel frustrated when patients cancel on short notice because we know we have a long list of patients who need and want an appointment time. As a result, patients feel unimportant, hygiene care is minimized, valued patients seek care elsewhere, and the team puts the recall system on the back burner.

What can you do?

Review your patients and schedule

First, review your patient database and determine what opportunities your practice has. Review your patients and schedule. Knowing the data prior to making a plan will help you uncover something you didn’t think was happening.

Here are some questions to consider:

  • Do you have open hours in your hygiene schedule?

  • How is your confirmation protocol?

  • Have you reviewed verbiage for scheduling patients?

  • Are you maximizing every minute of the hygiene schedule without gaps between patients?

  • How many patient hours do you currently have available?

  • How many new patients are coming into the practice each month?

  • Does your schedule allow growth for your new patients?

Verbiage: If your hygiene department has a high open hours average, it is time to review your confirmation protocol, the verbiage when scheduling, and how you schedule. Sometimes there are times we are communicating to our patients in a way that sets us up for failure and we don’t even realize it. If we tell them to call us if they need to make a change in their appointment, which creates the expectation that they can reschedule at the last minute. Instead, we should let them know that they will be getting a two-week reminder for their six-month recall. At that time, if their schedule has changed, they should give us plenty of notice to adjust the appointment. This creates the expectation that we need to have some notice.

Confirmation protocol: When you evaluate the confirmation protocol, is it reminding the patients of their appointment with plenty of notice or is it last minute? Reminding them of their appointment at the last minute doesn’t give them much time to adjust their schedule or their appointment if needed. When you give them a reminder that is two to four weeks before their appointment, that creates plenty of time to make an adjustment. But what if patients still don’t respect your time and policy?

Right fit: Unfortunately, from time to time, you will have patients who abuse the system. They show up late or cancel at the last minute. At the end of the day, you have to ask yourself if this patient is the right fit patient for your practice. It might be time to weed out some of the patients who waste your time.

Scheduling: When scheduling patients, do you allow gaps in the schedule, or is it fully booked? Ten- to fifteen-minute gaps add up over time and a few of those in the schedule could result in preventing one extra patient for that day. A few things that will help you from having open time in scheduling is using scheduling blocks; booking appointments at the top of each hour; having a firm scheduling protocol; and scheduling patients based on the right time versus their time.

Think outside the box: Once you have evaluated everything that is in your control, it is time to start thinking outside the box. You have improved your confirmation protocol, scheduling verbiage, schedule system, and reduced open hours. You still have patients you need to get in but have nowhere to put them.

Take action

When your current schedule is full and you need to get patients in, you have several good options to choose from or use in combination. Now is the time to create openings in the schedule to see additional patients who are new or overdue.

Adding hours or days: You can do this by simply adding days or hours to your work week. I know none of us want to work more days, so this can be where you get creative to add hours or days into the current schedule. Maybe the office is open three to four days per week, but you can have hygiene on a day the doctor is not in or work one Friday or Saturday a month. I know some are already maxed out on days and hours. This leaves no room to add more hours or days to the work week and figuring out how we can maximize the current working week.

Assisted hygiene: When adding hours or days isn’t an option, you can maximize your existing time in the office. If you have an extra operatory that hygiene can use, assisted hygiene works great. By doing assisted hygiene, they are able to see 50%–100% more recall appointments. With an assistant, hygienists can see more patients and be more productive.

This works great if you hire an assistant who has all the necessary expanded functions so they can be an asset to the hygienist. The assistant will be able to take x-rays, polish, apply fluoride, place sealants, and so much more.

Teamwork column: If assisted hygiene isn't a good fit for your practice, you can create a teamwork column for your hygiene team. This can be completely customizable, but it is a great place for patients who are not confirmed, kids under a certain age where the assistant can primarily do the entire appointment, or patients who need sealants. They hygienists will still have their normal schedule, but together they will be able to help care for the patients in this column.

Reduce in-network insurance plans: Reducing in-network plans will result in less current patients, and fewer new patients attracted to the practice. You might think this is counterintuitive, but this helps weed out the not-so-right-fit patients and allows room for more of the right-fit patients.

As published in Dentistry iQ August 17, 2023:


Amie Spurlock, Consultant

Amie Spurlock began her career in the field of dentistry in 2002 and has successfully held every position in the office, excluding the dentist and hygienist. She has also worked with many offices as a Certified Dentrix Trainer to help each office improve their workflows to better care for their patients and the overall practice. Amie is passionate about training and coaching teams to become key players in helping run a successful dental practice. With her experience she is able to identify and diagnose areas of opportunity and give workable and practical solutions.

Amie can be reached at:

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