Ask Kara RDH: How to address patients who are routinely late?

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Is there a polite way to tell a patient to come on time? I get that things happen and are out of their control, but I have a few patients that are always 10-20 minutes late for all appointments. What’s the best way to address this?

The offices I’ve worked at that run smoothly, on-time, and with the least amount of late patients are those that have a late (and no show) policy. All patients are given and sign a form, that in addition to the no-show policy, explains if they arrive late to an appointment, they may not be able to be seen or will only have limited treatment that day (depending on how late they are). The form explains the office respects a patient’s time, so the office asks to receive the same respect. Further explaining how one late patient can throw off the entire day’s schedule and it isn’t fair or respectful for the rest of the patients seen that day not to be seen at their scheduled appointment time.

If your office doesn’t have a late policy the office holds to, it may be time to come up with one. Otherwise,  even without a written policy, if a patient is always late, only give the treatment you can. For instance, perio chart, take radiographs, have the doctor do an exam, but then the patient must reschedule and come back for their prophy. After a few times of a patient needing to come back to finish treatment, they might try to arrive on time.

When taking this approach, explain to the patient to complete their treatment at the level they deserve, you really need the full scheduled time. This scheduled time is especially reserved for them, however, due to their tardiness, you are only able to do such and such, so they will need to return. Keep in mind if you do a prophy first, and have them return for radiographs, perio chart, and exam, they most likely won’t return, which is why I hold the prophy for the next appointment. If the patient asks why they can’t have their “cleaning” done first, explain the standard of care or best practices state or even “legally” you must “assess” before you “treat.”

With this said, it’s important your doctor(s) and the entire office supports this approach. It’s also very important the front office holds very strong to the late policy and never says, “This one time is okay, the hygienist will be fast and get all your treatment completed.” Doing so only awards for poor behavior and also shows your office policies don’t really hold true. Out of experience with this issue, and working for offices who hold strong to their late policy, I’ve noticed this approach can, more often than not, nip the problem in the bud with most patients.

This approach does eat up chair time, however, in the long run, if the patient begins showing up on time, it benefits the practice’s schedule and the rest of the patients seen.

Another option for patients who are consistently late is to tell them their appointment is 15-20 minutes before the real scheduled time. It sounds sneaky, but you can’t let them know your office is doing this. Otherwise, they know they have leeway and will continue to be late. This does benefit the practice’s schedule and the other patients seen. However, it still rewards for late behavior and doesn’t actually fix the problem.

Like you mentioned, sometimes things happen, and patients are late. However, for patients who are late every single time, some sort of consequence needs to take place. Otherwise, it will continue to happen over and over. It’s just not fair or respectful to the patients who do come in on time to their scheduled appointment to be seen late because of one person’s lack of respect for anyone else’s time. Patients might even leave a practice if they are always seen late, no matter what the cause. Take active steps to avoid this and best of luck in doing so!

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Kara Vavrosky, RDHEP
Kara Vavrosky, RDHEP, is a co-founder and the chief content officer of Today’s RDH, an independent educational publishing company for dental hygienists, encompassing articles, a podcast, virtual continuing education events, and self-study continuing education. Today’s RDH was launched in 2018 after Kara built her social media presence with her largest following on her Facebook page, Dental Hygiene with Kara RDH, which was created in 2013. An Oregon Institute of Technology graduate, Kara has a deep passion for spreading knowledge about the importance of oral health and its association with systemic health. Kara’s passion extends to helping other hygienists understand current protocols and evidence-based research – all with the goal of lifting dental hygienists and the dental hygiene profession. Kara was recognized in 2020 as one of the Top 100 Women in Media for her entrepreneurship as a co-founder of Today’s RDH. In 2022, she was recognized by the American Dental Hygienists’ Association for their Standout Seven Award in the Entrepreneur category. Kara lives in Vancouver, Washington, just outside Portland, Oregon, with her husband, Ben, and their four Chihuahuas. When she’s not working, Kara loves riding the Oregon Dunes on her quad, spoiling her Chihuahuas, and spending time with her close-knit family.