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RE: Cancellation/No show policy
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RE: Cancellation/No show policy - June 20, 2008 7:15:34 AM
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SJBird55
Posts: 2286
Joined: May 10, 2004
From: Michigan
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There is no right or wrong when it comes to cancellation/no show policies. I was just bringing a different perspective to think about. I prefer the choice I have made for the reasons I have provided. In my little SJ world, I fully trust that patients in general will do what is right; I trust that they will be responsible. I maintain this attitude toward them. Sure, a few times I've been burned by this attitude... but have I been burned at a high enough frequency to implement some policy? No. When I have been burned, reality is, it was my fault. Often times, I didn't get a clear handle on the patient's level of commitment. When I do speak to them, I learn that the person didn't really want PT; didn't really think PT would be helpful; really only wanted a quick fix; really didn't have time for the level of commitment I had suggested and I thought was agreed upon... through experience and the self-reflection that I tend to do, I don't have these types of scenarios happen as frequently because on the first visit, I openly discuss the patient's needs and how they think they can achieve their desired outcomes. I alter/accommodate my thoughts/recommendations to meet with their availability/level of commitment. It really doesn't matter to me if someone attends 1x/week... 2x/week... every other week. I just have to come up with some sort of process that might be different than typical to meet those needs.
I honestly do not know if patients value the services provided. I know I have excellent loyalty. I know that patients appreciate my commitment to them. I know patients will stop me in town and show/brag about how great they continue to do and thank me. "Value" I don't know. I generally maintain the attitude that they succeeded in their endeavors because of the work and time they put into achieving their goals. I just happened to be there and assisted in recommending the most efficient path to get them where they wanted to be.
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RE: Cancellation/No show policy - June 20, 2008 7:40:37 AM
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Sebastian Asselbergs
Posts: 1089
Joined: September 29, 1999
From: Barrie, Canada
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I agree completely that is no right or wrong.
However, in my Ontario society, having boundaries that are clear and openly adressed is a very important part of our practice standards. This involves ALL boundaries, including the contractual ones. Here we have to post our rates in a public place in the clinic, and having a cancellation policy is part of our mandate.
So, I think my approach to this is also heavily influenced by the jurisdiction I am working in.
PS: SJ, don't tell me that your patients never thank you?!? Don't tell me that your outcomes are not good! These things ARE signs of your "value".
And with regards to them missing appointments being YOUR fault? I guess it may be experience on my part, but frequency of treatment is ALWAYS a discussion between the patient an myself - and then the receptionist. First we find a workable time - for both of us - then we book. Two adults. If one then decides that they can miss that appointment without calling (rare as that may be) I then WILL have a policy in place to use - if I so decide.
< Message edited by Sebastian Asselbergs -- June 20, 2008 7:49:27 AM >
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RE: Cancellation/No show policy - June 20, 2008 9:52:11 AM
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SJBird55
Posts: 2286
Joined: May 10, 2004
From: Michigan
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Of course, experience is what taught me how to reduce cancellations. LOL I never had those kinds of conversations. I was under the assumption patients would do whatever you wanted them to do. LOL Sure I had to learn. It probably took me 7 years into my career before I figured that one out. LOL (I'm a slow learner... actually, initially I was always more worried about myself and the clinical aspect that reality was that I didn't put the person in front of me in the picture. I don't make that mistake now... but I definitely did for quite a few years after I first graduated.)
Value is an individual thing. What I believe to be as "value" may not be what a patient believes to be "value."
I'll be bluntly honest. No, my services are not of value. Generally speaking, if someone needs physical therapy services and I am out of network or non-participatory with the third party payor, I am generally not chosen. I can count on 2 hands over the last 3 years the frequency that someone really, really wanted services delivered by me and paid out of pocket. (I will tell you it is the coolest feeling when that happens... at the same time, it puts me mentally on edge, nervous and full of self-doubt only because I know that person can "fire" me at any time. I have to talk to myself and convince myself that I CAN deliver because I do it every day with all the other patients.) When I begin to see a change in the decisions to where patients choose me over in-network, I will then believe I provide something of value. As I continue to hear, "I know you're good and you come with high recommendations from many, but..." I'm not valued enough. My goal is for that to happen. I don't know how to get myself to that level, but I keep reading business books and I'm going to keep trying.
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RE: Cancellation/No show policy - June 20, 2008 11:05:00 AM
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orthotherapist
Posts: 201
Joined: February 6, 2007
Status: offline
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Maybe I missed it while quickly looking through these posts but lets ask the obvious What is your no-show/cancellation rate?
Is there truely a difference between those that have policies and those that dont.
I will start - Our rates are 10-15% historically - no phone reminders - we count anyone that cancels within 24 hours of their appt as a cancel
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RE: Cancellation/No show policy - June 20, 2008 11:10:31 AM
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orthotherapist
Posts: 201
Joined: February 6, 2007
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oh and no policy
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RE: Cancellation/No show policy - June 20, 2008 11:23:03 AM
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TexasOrtho
Posts: 400
Joined: December 22, 2007
Status: online
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Yeah...I mentioned our cancellation rates went from ~13% to 8% after starting the policy. It may not sound like much, but it makes a difference and the patients in this small Texas town still love us!
_____________________________
Rod Henderson, PT
Board Certified Orthopedic Specialist (or Super-Freak)
Certified Strength and Conditioning Specialist
www.texasorthopedics.blogspot.com
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RE: Cancellation/No show policy - June 20, 2008 11:29:21 AM
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Hpsg
Posts: 32
Joined: December 26, 2007
Status: offline
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My policy: cash practice, 24-hour notice for cancellation or patient must pay for missed appointment (quietly subject to my own discretion), treatment contract stating this is understood and agreed to must be signed before treatment commences. Case load consists in any given month of about 25% new patients. Valuing one's one time and valuing access to one's expertise definitely seems to keep other people from wasting them. I think as a side bonus it enhances the perception of the value of the profession.
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RE: Cancellation/No show policy - June 20, 2008 2:00:48 PM
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Sebastian Asselbergs
Posts: 1089
Joined: September 29, 1999
From: Barrie, Canada
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Never didn't have a cancellation policy. Have between 8- 17 new patients a week - average 14. No shows or short notice cancellations are about 1%-4% - do not have the year's stats in front of me.
Many appointments are 30 minutes+ these days - new ones are 30-60 minutes. My time is valuable to me and the patients who show up.
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RE: Cancellation/No show policy - June 22, 2008 3:54:40 PM
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jma
Posts: 2310
Joined: August 24, 2000
From: NY
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No shows along with a no call is grounds for discharge from our outpatient facility. They are also in the process of implementing an automated calling system to remind them of their initial eval.
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RE: Cancellation/No show policy - June 24, 2008 5:07:58 PM
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ianwvu
Posts: 64
Joined: June 11, 2004
From: Glendale, AZ
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My cancel/NS rate, is +5%. This means that not only do I have zero 0% cancels or NS's a week, but just because of the shear fear I strike into peoples hearts with my $40 fee, I have people that just show up for more appointments than they made, just to be on my good side. After all, you don't want to see me angry.
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RE: Cancellation/No show policy - June 26, 2008 5:11:16 PM
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ianwvu
Posts: 64
Joined: June 11, 2004
From: Glendale, AZ
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Tough crowd
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RE: Cancellation/No show policy - June 26, 2008 6:12:47 PM
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SJBird55
Posts: 2286
Joined: May 10, 2004
From: Michigan
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Ian, it is difficult to read humor.
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RE: Cancellation/No show policy - June 27, 2008 10:31:34 AM
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orthotherapist
Posts: 201
Joined: February 6, 2007
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Bas
Out of every 100 patients scheduled only 1 to 4 cancel or no show - wow that is excellent.
What do you consider a "short cancel", do you consider it a missed appointment if you are able to refill it, is your 1-4% only for new evals?
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RE: Cancellation/No show policy - June 27, 2008 9:52:55 PM
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ianwvu
Posts: 64
Joined: June 11, 2004
From: Glendale, AZ
Status: offline
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quote:
ORIGINAL: SJBird55
Ian, it is difficult to read humor.
I hope that wasn't the case, that means people actually took me seriously. Maybe I'm just not that funny. I guess my girlfriend was right after all....
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RE: Cancellation/No show policy - June 27, 2008 10:03:34 PM
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TexasOrtho
Posts: 400
Joined: December 22, 2007
Status: online
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quote:
ORIGINAL: ianwvu
quote:
ORIGINAL: SJBird55
Ian, it is difficult to read humor.
I hope that wasn't the case, that means people actually took me seriously. Maybe I'm just not that funny. I guess my girlfriend was right after all....
You'll be even less funny when you get married...it's a progressive disorder.
_____________________________
Rod Henderson, PT
Board Certified Orthopedic Specialist (or Super-Freak)
Certified Strength and Conditioning Specialist
www.texasorthopedics.blogspot.com
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RE: Cancellation/No show policy - June 28, 2008 8:33:02 AM
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Sebastian Asselbergs
Posts: 1089
Joined: September 29, 1999
From: Barrie, Canada
Status: offline
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Orthotherapist, those percentages are out of all appointments booked. There are times I WANT someone to no-show or cancel, for a coffee break....
Short cancels are those who call the day of their appointment - and yes, they are still counted - I usually do not refill them. It very occasionally happens when they call early and their appt is at 6 pm; but it really has to do with the fact that it is not easy to get their choice of appointment time with me - I am busy - and thus IF they get an appointment - they tend to do more to keep it.
Financially, I do not need the cancel/no-show-policy, but I use it as a clear signal of the agreement between pt-PT.
< Message edited by Sebastian Asselbergs -- June 28, 2008 8:37:48 AM >
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