HANDLING PATIENTS THAT CANCEL
From time to time patients will call and cancel their treatment schedule. They may do this for a number of reasons, such as lack of money or feeling better. It is important that the front desk knows how to handle these in a smooth and legal fashion.
A patient comes to our clinic to get specific recommendations to treat the condition that they came in to handle. The doctor will give the patient a specific prescription of care (expressed in terms of frequency and number of visits). The staff is there to facilitate the doctor and to ensure that the patients follow through with the recommendations as outlined by the doctor. Often times, the success of a patient's treatment program will depend on who is deciding what the patient needs - the doctor or the patient.
When a patient calls and cancels their treatment program, the Front Desk Coordinator must do everything possible to get that patient in to see the doctor.
We cannot just abandon a patient because they have decided they are "better" or that the treatment program is "too expensive", or because the patient feels they are "not getting any better". We also cannot abandon a patient because they are going to see another or different doctor.
The Front Desk Coordinator must use a lot of understanding and love, but must explain to the patient that the first step of their discontinuing care is to have a consultation with the doctor to review what has been done and the condition that they are in.
For example:
FDC: "Hello Mrs. Smith, I'm calling because you had scheduled an appointment for eleven this morning and we missed seeing you."
PT: "Oh, yes, I'm sorry I didn't call. I've decided not to come in anymore because I've been feeling so much better after last week."
FDC: "That’s wonderful to hear, Mrs. Smith. However, I’m not authorized to dismiss you from care. The doctor will have to make that determination. I would like you to come in for a no-charge consultation so that the doctor can discuss this with you. Would you be able to make it in at 2:00 this afternoon?"
PT: "Sure, that would be fine."
If a patient does not want to come in to see the doctor or is "too busy" to make an appointment, the patient should be put on hold so that the doctor can talk to them. It is important that the doctor make this determination and not the Front Desk Coordinator or the patient. The patient may have a serious health problem that treatment is affecting, and discontinuing their care could have serious consequences.
For example:
PT: "Well, I really don't think I can make it in. I’m just so busy I don't know when I can make it back."
FDC: "Again, Mrs. Smith, I can't authorize you discontinuing care without the doctor talking to you. I understand that you are very busy, and if you can't make it in to see him, let me get him on the phone to discuss this with you personally. I’m sure he’ll want to talk to you about this."
The Front Desk Coordinator should get the doctor on the phone with the patient. At times, it will be impossible for the doctor to talk to the patient. The FDC should explain to the patient that the doctor is busy but would like to call the patient later in the day. Get a convenient time, a home and work phone number, and put this on the doctor's desk.
A note should be made on the patient's treatment card as to what the patient has stated. All data should be forwarded to the doctor to handle when the phone call is made.
SAMPLE DIALOGUES
PT: "Hello, this is Mrs. Jones calling. I'd like to cancel my appointments because I broke my finger and I'll be seeing Dr. Fixbone for it."
FDC: "Oh no! You broke your finger? I'm sorry to hear that! Listen, you still need to follow through with the treatment program that Dr. ____ has outlined for you. Let’s get you in today to see Dr. ____ so that you can discuss your best options."
PT: "Hello, this is Mr. Jones and I'm just not feeling any better. I've decided that I'm going to Dr. Neuro to see what she can do for my back."
FDC: "Wow -- I'm really sorry to hear that you’re not feeling any better. I know Dr. ____ will want to talk to you about your decision. Can you make it in for today's visit? We won’t charge you for the visit, but I know that Dr. ____ will still want to see you today to discuss this. Why don't you come in at 2:00 as scheduled?”
PT: "I’m sorry, but I just can't afford to continue with my care right now."
FDC: "Mr. Jones, we have a very firm policy that we take care of our patients and that your care is more important than your money. Before you decide to discontinue care, I want you to come in and see Dr. ___ today and she/he can discuss your options. We won’t charge you for today's visit, and maybe we can discuss a financial plan that will suit your needs. You were scheduled at 11:45 - I'd like you to still make that appointment."
We have a legal, moral, and ethical obligation to our patients. Do not let them down by allowing patients to prematurely terminate care based on reasons other than the medical necessity.