Charging Cancellation Fees? Never A Good Idea….

I received an email from a dentist this week asking about the best way to charge cancellation fees.

Charging cancellation fees in a dental office is a big concern in this day and age as people and patients become so “instant”.

Let me explain. Here’s the email:

“My wife and I are torn at the moment regarding late cancellations and fees. 

We currently have an automated software system that sends patients an email a week before their appointment, then a text message the day before the appointment to confirm. Both tools giving the patient the option to reschedule if it doesn’t suit them. 

We are split in terms of opinion when charging late cancellation fees to first time offenders. We had a one strike rule where they would be let off on the first occasion but then started to charge $40.00 for any further failure to attend or late cancellation if the space could not be filled. 

For some background: We split our patient profiles into A patients, B patients and C patients. The latter being patients we don’t want and that waste our time resources and actually cost us money. The two former being our target conversions and ideal type of people we want to attract into the practice. 

It has had a mixed response from patients when they are being charged but it has been communicated in a very caring manner when the receptionist mentions that the dentist will be lying idle for that hour and we have a long waiting list of people looking to see us and you have wasted that space. 

I was just wondering if you had any advice given your experience?”

This is a really great question being asked by this doctor, and is a problem for so many dental offices.

Let’s break this down into a few of its sub-components and see if we can get a very valid solution going here.

Firstly, why do people cancel and no-show for dental appointments?

The reason this happens is simple.

This happens because our patients do not CLEARLY understand the reasons why they are coming back for their next appointment.

Clarity is king.

When the patient is unclear they will defer or no show.

After all, most of the time the patient is returning for us to fix something that is not hurting them, and it is usually something that they were not aware of.

So we need to let the patient know exactly what we are going to do.

And we need to be sure they understand us.

When the patient is totally clear, then they will attend.

If we allow a patient to leave our office or to get off the phone after scheduling without them being totally clear as to the reasons why they are scheduling, they will cancel, and we as their health care practitioners have now let our patients down.

Here is what the patient needs to know, EACH AND EVERY TIME.

  • What tooth or teeth are being treated next visit
  • What is wrong with those teeth
  • What we are going to do for those teeth
  • When exactly we need to do this treatment
  • What will happen if the teeth are not treated in THAT timeframe, and the consequences of delay or inaction
  • And if a change to our schedule arises, then the doctor will want to see you sooner.

When we visit each and every point on this checklist each and every time we schedule an appointment then we dramatically increase our patients’ attendance rates and decrease their no-shows.

So long as our patients have that CLARITY.

We must ensure that the patient has understood and has committed to us [verbally] that they have understood.

There is no point in us making appointments and “hoping” that our patients will keep those appointments.

There must be clarity. And commitment.

Secondly, don’t leave the windows open.

“What do you mean David?”

Confirm the appointment at the time of scheduling the appointment.

And close the open window.

Use these words:

“And I’m confirming that appointment with you right now Betty.”

“And that appointment is now CONFIRMED.”


We have a TV game show down here where contestants choose their answer from a group of four choices and then tell the host to

“Lock it in, Eddie.”

And their answer is secured.

Be as definite with your scheduling at the time of scheduling.

Also, when you allow an automated process to give patients an exit from an arrangement they have previously secured, you are creating open windows for your patients to escape through.

Don’t do this.

Don’t allow your staff to speak in this manner either.

The classic escape hatch is the message on the appointment card that reads:

“A fee will be charged for all appointments cancelled with less than twent- four hours notice.”

All this message serves to do is to say that patients could secure a time for as long as they want, and then could cancel with our blessing as long as they give more than a day’s worth of notice.

Of course that is so wrong!

How many times could we have filled that appointment if we’d simply had more advance notice of the cancellation?

Don’t play that game.

Lock the appointments in with definite language.

Thirdly, reliance and dependence on automation over people-contact increases the number of cancellations and no-shows.

Our patients will feel less guilt when cancelling to an automated message or automated text.

If your office can actually have a human being providing the “courtesy call” you will dramatically increase your attendance rates.

“Hi Betty, it’s Jayne from Active Dental calling. Just to let you know that David is looking forward to seeing you tomorrow at 10:30. See you then.”

This greeting can also double as a voice message left, with the tail:

“Please call me back on 9123- 4455 to let me know that you received this message/text”

Note what we have not done:

  • We have not called to “confirm”. Adults hate to be confirmed.
  • We have not called to “remind”. Adults hate to be reminded.
  • We have not granted them permission to reschedule.

What else?

When scheduling the appointments, don’t intimate to the patient that you will be calling or contacting them to remind them.

Just do the courtesy contacts anyway.

I remember discussing this with a female periodontist. She said whenever she makes an appointment with her hairdresser, they simply just make the appointment. A couple of days prior to the hair appointment she receives a text message on her phone. At no time do they tell her they will be texting her a courtesy message. They simply do it. As a courtesy. Not as an escape route.


The email from the dentist above shows that he and his wife are definitely on the right track in terms of identifying their target markets and the types of patients they prefer to be treating.

Most dentists don’t do this.

Most dentists simply try to be everything to everybody.

And in the end they finish up failing to be anything significant to anyone.

By identifying the types of patients that you enjoy treating in your dental office you can focus on attracting and pleasing and keeping more of those patients that make your life enjoyable.

Twenty to twenty five percent of the population are happy to pay your fees and don’t care what your competitors are charging, simply because they believe you are doing a wonderful job. Focussing on these people will provide you with eighty percent of your income.

These people will not cancel and reschedule on you.

Because they value you and what you do, and how you treat them.

Attracting more of these people should be the goal.

Should you charge a cancellation fee?

I never charged a cancellation fee.

However, I did terminate patients who became repeat offenders and serial offenders.

Should you have a cancellation policy?

I don’t believe any business should have “policies”.

Of any sort.

The display or existence of a “cancellation policy” is an indication of a loss of control.

Focus on clarity and necessity of treatment. And understanding.

And do business with those people that you want to do business with.


My next public speaking presentation showing Dentists how to grow their Dental practices will be at a Symposium on growing your Dental Practice in 2018 in Sydney Australia on Saturday December 2 2017 with leading experts Kinnar Shah, Angus Pryor, Jayne Bandy and Toni Surace .

For more information and to secure your seat click this link here.


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The Ultimate Patient Experience is a simple to build complete Customer Service system in itself that I developed that allowed me to create an extraordinary dental office in an ordinary Sydney suburb. If you’d like to know more, ask me about my free special report.

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