When clients are late and miss their appointment times, an option may be to have them wait for an opening or a “work-in.” You’ve heard the excuses: “I got stuck in traffic.” “I had to crawl under the bed to catch my cat and wrestle to get him in the carrier.” “I was in a meeting that ran late.” Whatever! When one client arrives late, it causes a domino of late starts for the day’s remaining appointments. Multiple consequences happen as a result: 1) Your team looks disorganized, 2) Late arrivals increase wait times for on-time clients, and 3) Your medical team feels rushed. With current out-of-control appointment demands, you must be the boss of your schedule. You want to be able to give each client and patient the full amount of time set aside for their appointments. Let me share options to handle clients who are late for appointments. Create a late policy While clients may occasionally show up late, habitually tardy clients disrespect your time and services. You can prevent this bad behavior. Just as your hospital has a financial policy, introduce a late and no-show policy holding clients accountable and setting expectations in a professional, respectful way (see my article on “Four ways to end the no-show crisis” in the February issue). Add the policy to your new client registration, online patient history forms, and online or app scheduling tools. Here is a sample late policy: “We ask you to arrive before your scheduled appointment time so you may benefit from your full exam time. New client and patient history forms should be completed in advance to help our medical team prepare for your pet’s visit. A grace period of __ minutes will be granted for unforeseen delays you may encounter while traveling to our hospital. If you arrive more than __ minutes late for an appointment, we will offer options of being seen as a work-in, day admission, or rescheduled if our schedule permits. “We strive to ensure clients and patients are seen in a timely manner and appreciate your on-time arrival. Clients who have three or more late arrivals for appointments cannot schedule future appointments and will only be seen as emergencies or day admissions. Additional fees will apply.” Start with a warning on the first offense. Explain, “I understand you were 15 minutes late to your appointment today. We want you and your pet to benefit from the full exam time with our medical team. “To best serve you, please be on time for future appointments. We send confirmations upon booking and reminders two weeks, four days, and two days before your exam. Let me confirm we have your correct cell number for texts and your email. We appreciate your timeliness so we can give all patients the time they need.” Put alerts in your practice-management software. Track the number of times a client is tardy to identify when a one-time occurrence becomes a chronic behavior. I follow a “three strikes and you’re out” policy. Forgive a first offense. You have been unexpectedly delayed in traffic, too. When you observe three late arrivals within one year, decide whether to keep or end the client relationship. Allowing the chronic behavior to continue is your fault. Text clients when they are five to 10 minutes late. This puts you in control and lets you determine options for the late-arriving client. If you see appointments every 15 minutes, send the text when the client is five minutes late. For 30-minute exams, reach out when the client is 10 minutes overdue. Send this text: “We expected to see you at 3 p.m. for Max’s appointment. Reply YES and your expected arrival time if you’re on the way here, or RS to reschedule.” Obviously, clients should be expected to follow laws about not texting while driving. Show appreciation when clients call ahead This is honest and conscientious behavior. Reply, “Thanks for calling to let us know. What time will you arrive?” If you get a vague response of “I’m leaving my house now,” ask again, “What time will you arrive at our hospital?” Reply with, “Thanks for letting us know. Please drive carefully. We look forward to seeing you soon.” Do not make promises over the phone. If the client is 25 minutes away and has a 30-minute appointment, only five minutes of exam time will remain. Explain, “Once you get here, I will let you know options for us to see your pet today.” Never punish on-time clients by letting a late client cut in front of them. Once the client arrives, look at your options. Option 1: If the client arrives a few minutes late with three-fourths of the appointment time remaining, go ahead and see the patient (20 minutes of the 30-minute appointment remain). Alert a technician or assistant who can start the appointment now and help get the schedule back on track. Option 2: See another doctor if one is available. Explain, “Dr. Jones has started his next appointment. Dr. Smith can see you now. Let me take you to Exam Room 3.” Unfortunately, every veterinarian at your hospital is likely fully booked with the current appointment demand. This option may be a rare choice. Option 3: Ask if the client can wait and be seen as a work-in. Explain, “Dr. Jones has started his next appointment. We want Max to get the care he needs. We will see Max as soon as the first doctor becomes available, which may be 45 or more minutes. Are you able to wait, or do you prefer to reschedule?” Option 4: Offer to reschedule. Use the yes-or-yes technique, focusing on what you can do. Say, “My next available appointment is Feb. 22 at 9 a.m. or Feb. 23 at 2 p.m. Which do you prefer?” Option 5: Offer a day admission. Never use the term “drop-off,” which is tacky and unprofessional. Explain, “We can see your pet as a day admission. For 10 to 15 minutes, you will meet with a technician who will get your pet’s vital signs, ask questions about your pet’s symptoms to share with the doctor, set a pickup time, and provide the expected cost of care. Because your pet will stay with us throughout the day and receive nursing care, there is a day admission fee of $XX. Shall we admit your pet to the hospital, and have you talk with the technician?” I advise charging a one- to 12-hour hospitalization or boarding fee to cover the cost of nursing care. The Veterinary Fee Reference, 11th ed., reports an average fee of $48.94 for hospitalization without an IV and no overnight stay (day hospitalization) for a 25-lb dog, $49.97 for a 60-lb dog, and $47.28 for a cat.1 Boarding fees for 30- to 60-lb dog in a medium run average $27.29, while cat boarding is $21.07. For consistency and simplicity, I suggest creating a flat rate for day admissions, such as $50. This day admission fee is charged in addition to the exam fee and other services. Options to see late-arriving clients will vary based on your schedule in that moment. You may only have one option or all five available. When a late client arrives at your hospital, your goal is to be a problem solver. You’ll hear words of thanks from the client for making care happen. When you commit to setting clear expectations and follow your late policy, you will stand up for your time, your schedule, and your employees’ mental health. Remember, you train your clients how to treat you. Wendy S. Myers, CVJ, has been training veterinary teams for 22 years as owner of Communication Solutions for Veterinarians. She teaches teams to become confident communicators, so more pet owners say yes to medical care. Myers shares her expertise through conferences, online courses, and monthly live CE credit webinars. She is a certified veterinary journalist and author of five books. Her passion is to help practices like yours thrive and grow through effective communication skills. You may reach her at wmyers@csvets.com or www.csvets.com. Reference The Veterinary Fee Reference, 11th ed., AAHA Press:2020; 245, 264, 248, 104, 105.
