Encouraging Greater Compliance

By Roger P. Levin, DDS
Roger LevinCompliance means more than just patients complying with instructions for good oral health care. For efficient practice operation, compliance should be addressed in three other areas as well:

  1. Patients not showing up for their appointments
  2. Patients not showing up on time for their appointments
  3. Patients/parents not paying for treatment

It is important to understand the impact of these forms of non-compliance and develop techniques for minimizing them.


1. Patients not showing up for appointments

The financial impact of no-shows, even if they call to cancel, is devastating because they lead to a high rate of overdue debonds. Ortho practices should therefore set a target of no more than 1% no-shows and last-minute cancellations. This goal can be attained with scripting that strongly emphasizes the value of each appointment, polite reminders of consequences when patients fail to show and, in chronic cases, a conference explaining that the patient will have to be debonded and treatment stopped if there is another incident. Most patients/parents will commit to better compliance as a result of these techniques.

2. Patients not showing up on time for appointments

Though this is not as serious a problem, it does nevertheless cause significant schedule disruptions that will inconvenience and irritate other patients and parents. If a patient has been late by 10 or more minutes twice in a row, tell them an appointment time that is actually 20 minutes earlier than what is entered on the practice schedule. If this fails to correct the problem, send them home without being seen. Fortunately, this more drastic step is rarely necessary.

3. Patients/parents not paying for treatment

The tight economy has forced many people to juggle bills, including those for ortho treatment. If there are no consequences for late payments, paying the practice can more easily be put off. Counter this by calling the patient or parent when payment is one day late and weekly thereafter. After two missed payments, hold a conference in which the family is encouraged to arrange for outside financing as a way to avoid debonding, which will be necessary otherwise.

Some orthodontists are reluctant to seek compliance in these areas, but they must realize that with the right techniques and excellent scripting to motivate and build value, patients and parents will most likely comply with the practice’s requests.


To learn how to run a more profitable, efficient and satisfying practice, visit the Levin Group Resource Center at www.levingroup.com/ortho—a free online resource with tips, videos and other valuable information. You can also connect with Levin Group on Facebook and Twitter (@Levin_Group) to learn strategies and share ideas.


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