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The Value of an Appointment

In our town, the regular way a person attends a dental office for treatment or for an examination is by making an appointment. In fact, it is so common that often we don't even consider what an appointment is. An appointment is good for everyone.

An appointment is beneficial for the dentist and the dental staff because they are able to plan the use of the time in the office efficiently. It is beneficial for patients because they can show up at the office and know they will be treated without a long wait. By now, you probably understand that an appointment is based on trust. For instance, if your dentist runs behind an hour all the time, you might decide it is in your best interest to show up an hour late so the hour will not be lost. The same goes the other way. If a patient always shows up half an hour late, the office staff might begin to schedule the patient half an hour before the dentist will actually have the time to see him.

I used to work in a free clinic in Iowa at the last part of my dental school training at the University of Iowa. The clinic was operated on a walk in basis. Patient treatment started at 8am. Patients started waiting in line for treatment sometimes as early as 7am and they were seen as space in the clinic became available. Since lineups were usually small in the early morning, this way of delivering treatment was efficient for the patient only if he showed up early in the morning. By lunch time, the lineup was typically so long that it was not a sure thing that the patient would be seen at all on that day. Many government clinics are run in this way (on a walk in basis--no appointments). The reason the government clinics are operated this way is that on a cost basis, walk in is the most efficient way to run a clinic as long as there is too much work to be done by the available dental staff. This is so because there is no down time. Every minute the dentist is in the clinic, there is a patient he is treating in the dental chair. Down time is expensive because most of the costs of operating the clinic continue even if there is no patient in the dental chair. Things like staff salaries, heat and lights, insurance, and just about every other cost of doing business are the same whether a patient is being treated or not.

An appointment is granted because the dentist trusts the patient that he will attend. The patient accepts the appointment because he trusts that the dentist will deliver the service with a minimum of waiting time if he comes to the office when he has agreed to show up. As long as both parties (the dentist and the patient) stick to what they have agreed, appointments are efficient for everyone.

Many offices charge a missed appointment fee. The fee is not meant to cover the cost of running the office during the time the patient missed. Missed appointment fees in our area run from about $25 through about $75. The cost for a dentist to operate the dental chair for an hour is several times that much, and as mentioned before, just about all of the costs are incurred whether a patient is being treated or not. The purpose of the missed appointment fee is to try to keep the patient from missing again. Some offices will go to great lengths to make sure the patient is contacted within 24 hours before an appointment and some will even cancel the appointment and find someone else to fill the time if the patient cannot be spoken to directly within 24 hours. It is wise to let the office staff know what happened to cause you to miss because often after missing a couple of times, either no more more appointments will be booked by the office and the staff will call you to fill another patient's missed appointment instead, or in some cases the office simply will not see the patient any more. This can be expensive for the patient as well as the dentist because when a new dentist is found, an initial (complete) exam will have to be done to assess the condition of the mouth that the new dentist has never seen before, and the patient will have to bear the cost of that initial exam at the new office.

At present, there is no place a patient can go in our town to be seen on a walk in basis. So, unless a patient is planning on traveling to Winnipeg he must learn how to attend an appointment for dental examinations or treatment to be done. If you want to know more, ask your dentist what policy is in place regarding appointments at your office.

- This article was written by Dr. Mike Christensen and published in the Daily Miner and News, and Enterprise. Local Kenora News Publicatons (1998-2006)

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