Pre-appointing

[Cowboy]

Hello Fellow Optiboarders,

My question is this - well, kinda in multiple questions; Do you believe that pre-appointing is an effective vehicle to draw back patients? We have been doing so for about six years and we acheive about a 60% return rate, we do however lose the other 40% and the slots become no-shows. There are opportunities to fill those slots, but we are unable to verify if those patients will actually come in, so we lose the opportunity to refill that slot. Now, the Doctor wants to elliminate the pre-appoint system for all routine vision care, with the exception of annual contact lens appointments and medical diag. patients. I understand the CL patients - take them out of the market, but, if we do not draw back the routines, are they not put back into the market for someone else to pick up? According to the doc., there are two thought processes on this topic; 1. Pre-appoint will get some back but not all and not all will purchase - wasted time and energy to get them back. 2. Don't pre-appoint (routine's) fill with medical and cl patients and just hope that service provided to routines had a positive impact to get them to return in 18-24 months.
I am an advocate for pre-appointing regardless of the thought process, because of many factors - keep them in your location. Yes, you will lose some, small price for an inexpensive marketing tactic. Industry is constantly changing, and economic situations fluctuate, keeping a patient out of the market and in your location is crucial to survival. Private practice is much different than retail operations and every edge is important. Etc., etc.
I know I rambled a little bit, but I am a little frustrated with the doc's inability to see my point - so I am turning to you optiboarders to either shut me up or support my theory. Thanks for any input you can provide.
:cheers:

Cowboy

[AdmiralKnight]

Hello Fellow Optiboarders,

There are opportunities to fill those slots, but we are unable to verify if those patients will actually come in, so we lose the opportunity to refill that slot.

Why can't you verify? Does your office not call to verify appointments? Here, our front staff calls everyone who's due to come in 3 days later. For instance, if it's monday, they'll call everyone who's due to come in on thursday. Make sure they're actually coming. If not, it gives them three days to fill the slot. Now, I guess this would depend on man-power, how many people you have calling, vs how many patients you have in the day. I think pre-booking is the way to go though. You can spend the money on mail-outs, but there's less of a chance they'll come back. If you've already made the appointment, then it's there for the px, and they don't have to worry about it. The only real problem with pre-booking is people forgetting. I mean, I have trouble remembering an appointment two weeks from now, let alone two years. That's where the calling comes into play though. Give me a call and remind me, chances are, I'll be there.

[Cowboy]

We have the patient write their name and address on the pre-appoint card (so they recognize their own handwriting) then mail it to them 1 month before, call 1 week before and 1 day before scheduled visit - however, some do not reply to messages, are unable to speak to, or, just not reachable. We then cannot verify whether they got the card and are coming in or not. What the doc concluded is to just get rid of pre-appointing as previously described in my first discussion. I would rather see the unreached pre-appointed px put off to the side if they do not respond to the card, or cannot verify 1 week prior to pre appointed slot. I find that to be great compromise as now it opens the slot, but also gives the opportunity to be doubled booked - nothing wrong with that either - more productive dollars per hour!!
:cheers:

Cowboy

[AdmiralKnight]

Do you often get patients you can't reach? If it's only once and a while, I'd say go ahead and double book, if they both come in, oh well, gotta sweat a bit, but if you're getting a lot and half you patients end up like that, then I wouldn't suggest it.

[For-Life]

Personally, when I am pre-appointed a year in advance, unless it is a place that is impossible to get into, I switch.

Who here knows what they will be doing in one year? I will not have that dictated to me by a business I am funding.

[cocoisland58]

Personally, when I am pre-appointed a year in advance, unless it is a place that is impossible to get into, I switch.

Who here knows what they will be doing in one year? I will not have that dictated to me by a business I am funding.

My feeling exactly, therefore I won't book our patients a year in advance. Recall cards work just fine. I quit my dentist because, number one they wanted to pre-book and number two they called me on the phone to "remind" me I was due for my cleaning. I'll decide when I'm due thanks. The thing is, before they went to the "pushy" system I always went in the month I was due, and I didn't need anything but a postcard reminder.

[Cowboy]

Your personal needs are not what I am looking for - I am looking for business minded individuals who think beyond themselves. What you would do with your dentist is not the consensus of all consumers - I will say majority of our patients prefer to be recalled - even if they don't know where or what they will be doing in a year or two - but they will know that they don't have to call to book an appointment - its made for them and most appreciate the effort we make for them as it does make them feel important, valued, and cared for - not inconvenienced for funding us. You will be funding someone else who doesn't care about you or your needs.

As for the amount we cannot reach, very few. I know that you can never escape the no-show rate, even with those who call to book an appointment the day before may not show - I am just trying to figure out if it is worth keeping based upon the dynamics of my origonal post.:cheers:

Cowboy

[For-Life]

Your personal needs are not what I am looking for - I am looking for business minded individuals who think beyond themselves. What you would do with your dentist is not the consensus of all consumers - I will say majority of our patients prefer to be recalled - even if they don't know where or what they will be doing in a year or two - but they will know that they don't have to call to book an appointment - its made for them and most appreciate the effort we make for them as it does make them feel important, valued, and cared for - not inconvenienced for funding us. You will be funding someone else who doesn't care about you or your needs.

As for the amount we cannot reach, very few. I know that you can never escape the no-show rate, even with those who call to book an appointment the day before may not show - I am just trying to figure out if it is worth keeping based upon the dynamics of my origonal post.:cheers:

Cowboy

I am a business minded person who thinks beyond himself. I think of the customer, and put myself in a relateable position.

You send them a reminder a month in advance to book an appointment. Those who want one every X amount of time will book, and you will get a high turnout rate. Those who do not, will not book, and there is nothing you can do to get them back in on that date.

[ADO]

Why can't you verify? Does your office not call to verify appointments? Here, our front staff calls everyone who's due to come in 3 days later. For instance, if it's monday, they'll call everyone who's due to come in on thursday. Make sure they're actually coming. If not, it gives them three days to fill the slot. Now, I guess this would depend on man-power, how many people you have calling, vs how many patients you have in the day. I think pre-booking is the way to go though. You can spend the money on mail-outs, but there's less of a chance they'll come back. If you've already made the appointment, then it's there for the px, and they don't have to worry about it. The only real problem with pre-booking is people forgetting. I mean, I have trouble remembering an appointment two weeks from now, let alone two years. That's where the calling comes into play though. Give me a call and remind me, chances are, I'll be there.

I would like to echo these comments. Very well put!

You can never make everyone happy. Your job is to put the system in place that makes the majority of your patients happy. If 95% of your customers are coming in more and spending more it will more then make up for the few who leave because they don't like it.

When I managed a practice we would send the reminder card a month out from the appt. It asked that they call to confirm their appt. or reschedule. If we had not heard from them in two weeks we called them. If they have not responded to the call or mailer at 1 week before their appt. we opened up the slot.

Good Luck.

[Jubilee]

We pre-appoint for our patients a year in advance. We will send them a letter about 5 weeks in advance reminding them of the need for an annual eye exam and explain we have a time reserved for them at the particular date / time we have pre-appointed them for. We ask on the letter that they call and confirm this appointment with us.

2 weeks prior to their appointment, we call any non-confirmed patients and ask that they confirm their appointment or let us know if we can make another time/date convienent for them.

1 week prior to the appointment, any non confirms get a "24hr" reminder call letting them know "If we do not hear whether this time is convienent for you by the end of business on (the following day), we will assume that this is not a good time, and take you off our books till you can let us know when a more suitable time will work for you"

This gives us almost a week to fill in any slots that may have opened up. My rules is we keep at least 5 appointments open in the morning and afternoon for new or existing but not pre-appointed patients. That way you still can get patients in the office in a timely manner.

It does take a bit of time, and approximately a couple of hours a week.. however we seem to have about 60% that keep the appointments as is, 30% that reschedule to a different time, and 5% no show, and 5% cancel outright..

One thing we do is if we get letters back (due to address change, etc) we will send a new letter if the forwarded address in on the label, or attempt to call if we have a cell # on file, etc.

Any patient we can not contact due to disconnected numbers, returned letters, etc will simply be taken off the books. If letter was not returned but we can not reach someone via phone to confirm, we give till one week before and then take them off the books.

We have patients that have come to rely on this system. They even ask if we are upset with them if we somehow mess up and miss sending them one..

In general we will give reminder call 24-48 hours in advance for all patients (pre-appointed or not)

Cassandra

[wolfman]

I know of a local opthalmologist office who does pre-appointing a year out. One month before they will call the patient, one week before they will call again and the day before. The problem is if the patient doesn't respond they cancel and fill up the slots. The nonresponsives are an average of 15% of the daily patients that are prebooked. If the nonresponsive patient shows up then they see them. Now this doctor already sees on average 90 patients a day, (plus office calls) so what happens when some of these nonresponsive patients show up for a doctor who is already overbooked? 3 hour delays and :angry: patients, who don't want to come back. Is it worth his reputation and the stress it puts the staff under for a couple of extra dollars?

[optical24/7]

One aspect of pre-appointing not mentioned but related to the subject is how important it is in selling your practice. You may have no intention of selling today, but when an office has a years worth of pre-booked patients, your practice will sell faster and for more money.

[Jubilee]

When we have a patient that shows up that had not confirmed, we will see how our day is.

If we have time to fit them in without destroying our schedule, we will fit them in. We will politely remind them that we ask that they confirm the appointment in advance.

If it is questionable, we will tell them that we're sorry they did not confirm their appointment. We will be more than happy to try and work them in, however SCHEDULED patients will come first and the person who didn't confirm may have to wait to be seen.

If we are already behind, we will politely inform the patient we are sorry that they never confirmed their appointment, however they were warned that we would offer that time to another person. It has been filled, but we are more than happy to set up an appointment for another day/time.

We will not jeapordize our reputation for timeliness over this issue.

[chip anderson]

Depends on how far in advance the Pre-appointment is. If it's over 6 months you gonna spend too much time with yourself. In fact my artificial eye patients have a less than 40% return for a free six-week follow-up. This is especially true if they are third party funded. They have what they wanted and don't come back until there's a problem. This would actually be all right if they would just tell me in advance so I could use time cleared for them in other pursuits.

The longer you have pre-appointed the more no shows you gonna have. Many can't remember a couple of days. Especially if they conciders themselves to be socially impotant. They may show but chances are it will be at the wrong time without an appointment. After all they be much mo impotant than you is.

Chip

[Jubilee]

I get more no shows from people making their appointments 1-5 days in advance, than I do from our pre-appointed people. Not sure if it is cause they have a written reminder.. or the "new" patients we are pursuing are clueless and disrespectful.

It really kills me the people who call in the day before, and then miss. I just wrote a letter dismissing a patient since she no-showed again. Of course she has glaucoma but can't afford to be seen as often as she should.. or take her drops..or be bothered to come in for a FREE Visual field. Explained the importance of these visits many times. She calls in to schedule her appointment now she has ins.. and still NO SHOWS. When she made sure we had all her insurance info the day before!!! We politely forwarded all records to the ophthamologist she worked with in the past and encouraged her to seek all her services through him and soon before she goes blind...

Cassandra

[MedicLINK]

Some very interesting points and responses here.

For those who haven't viewed it, theres a relatively recent posting entitled "Business Practices" that also discusses and highlights this debate.

http://www.optiboard.com/forums/showthread.php?t=23990


Cheers,

[drk]

My humble opinon:

Good reason for preappointing: helping a patient
Bad reason for preappointing: make money.

Hey, some of your patients are idiots, but most aren't. They know.


Here's who pre-appointing helps:
I. Refractive care:
A. CL patients--save them the hassle of running out of contacts and having to get in in emergency-mode.

B. Kids with diagnoses--get them in before school. It's easier on the parents.

II. All medical patients
Some would say appointing the next visit is the standard of care...It's not really in the purview of "pre-appointing" is it? It's just scheduling needed followup care. What else could a responsible physician do?


Pre-appointing, in the purest, most literal sense, is pre-scheduling routine care as opposed to waiting for an urgent need--like servicing your auto, or having a service contract on your heating/cooling system at home. It's a tough sell to pre-appoint routine, preventative care because most people don't operate pro-actively.


LISTEN TO YOUR DOCTOR, S/HE'S WISE!

[ADO]

My humble opinon:

Good reason for preappointing: helping a patient
Bad reason for preappointing: make money.

Thats the great thing about preappointing....it leads to both!!

Here is a great test to see how receptive your patients are to hearing from you. We did this and it lead to some huge months for us and made many of our patients very happy.

Call every patient who you have not seen in the last 3 to 4 years. Tell them that the Dr. asked that you call them because he/she noticed that they are over due for their eye health check. Then ask them if they would like to make an appointment. I can tell you we did this with our doctors and we booked hundreds of appointments like this. Then when they came in we pre-appointed them for the next year. That way time would not get away from them again.

We did get some patients who told us that they would call us when they were interested, but many of them were greatful for the call.

The people making these calls were initially very timid about it, but after a day or two they saw the results and were very excited. After they finished this list they voluntarily called patients who had not been in for even longer.

This was so successful that we hired a part time person to come in and make these calls in the evenings and weekends. They more then paid for themselves.

Once you do this you will see that the vast majority of your patients don't mind being contacted by you and they value your services. Pre-appointing is just a natural flow from there.

Try it...you will love the results.

[drk]

I think that's fantastic, I really do. I think it is a big win-win.

That's not really preappointing, though, that's recall.