How to Keep a Full Schedule at Your Private Practice

Keeping your private practice schedule full requires careful management of your scheduling policies. You’ve got to have a strong cancellation policy that you actually enforce. You’ve got to have different types of schedules that you use for families that can’t seem to make it to all their appointments. These procedures go a long way to helping that schedule stay full.

Getting Families to Comply with Your Practice’s Cancellation Policy

The first thing to know is that you have to write a cancellation policy that works with the culture of your practice. It should be strong and it must be read and signed on a parent’s first visit. It’s so important that I recommend that you review it on the second or third visit, too. The first visit can be so busy that they don’t really pay attention to it.

Next, review this cancellation policy with every parent, every year just to be sure that they are completely clear on it. Most people sign it without reading it. So it’s worth your time to review it with them.

It’s important to help parents understand the reason for this policy. It’s not so you can make more money. It’s to ensure the child’s consistency of progress. If the child is not coming to their appointments, they are probably not working on their skills at home—maybe not at all or maybe not as much as they really need. Consistency of therapy, consistency of progress is crucial.

The Importance of Reviewing a Child’s Therapy Attendance

You should periodically review each child’s therapy attendance. If you find that they are only attending 50% of their visits, the child will not make as much progress as if they were attending all or nearly all of their therapy visits.

In this situation, your team needs to come up with a solution so the child can attend 90% of their scheduled visits. Would it work better to cut back the frequency? Should the day and time or therapist be changed? Have these conversations with the family and see if you can work out a solution.

Why Some Families May Need a Flexible Treatment Schedule

Sometimes the best option is to offer the family a flexible schedule. A flexible schedule enables you to work with a family that is not making their appointments while avoiding a situation where they are going to go out and leave a negative review on social media. You don’t need them telling their friends that your practice is terrible. If they are going to be taken off the schedule, you want them to take themselves off.

How to Offer a Flexible Treatment Schedule

You’ve got someone on a “perm schedule”—same time, same day, same therapist, every week but they aren’t making these appointments. The first thing to do is increase your caring and increase your help. Start the conversation like this. “I can see having such a rigid schedule—same time, same day, same therapist,—is not working for you. Here’s how often you’ve attended in the last eight weeks or 12 weeks.” Show them their attendance record.

Maybe the family says the child has been sick or that the car isn’t working or the parents’ work schedules are difficult. You can reply: “I know it’s a challenging time. I totally get it. But I’m here for you. I care about you. I care about you so much, and I want to help Johnny so much that we’re going to move you to a flexible schedule.”  (Notice I didn’t say “we’re going to have to.” )

Continue explaining the flexible schedule like this: “I’m going to help. We’re going to move you to a flexible schedule. Here’s how it works. It’s perfect for your family right now. You’re going to call us when the time and day is perfect for you. When Johnny feels good…when you have the gas money… when your work schedule smooths out, you’re going to call us and we’re going to get you in that week. We have cancellations every day. True, you may not get the same therapist. I’m going to work hard to get you with the same therapist. But we have many, many fabulous therapists. I think what you’re going to find is you’re going to get more progress with that schedule because right now you’re not attending and Johnny’s not getting progress.”

Show You Care When Moving to Flex Schedules

With the flexible schedule, we tell them to call us when their schedules allow them to make it into the practice. But we also call them when we have openings because we want to fill the schedule.

If you open the conversation by saying that you “are going to have to” move them to a different schedule, it sounds like punishment. So skip anything that sounds like that. You’ve got to have the ability to confront a parent comfortably with assertiveness, not aggressiveness. I’m not punishing a family. I’m helping them move to a schedule that works better for them.

Sometimes families are on a flexible schedule and they aren’t even making those appointments. They call on Monday and set up an appointment for Thursday and they’re not making it. We move them to a same day schedule. They’re only allowed to schedule an appointment if they call in the same day.

Train Your Staff How to Schedule Therapy Appointments

First, you need to care enough about your families to have these alternate schedules, and then you need to train up your team to have these conversations with the family. Staff should realize that this change is not a punishment. We’re not kicking anyone off. We are getting them on a schedule that works for them.

There’s another possible outcome of offering these alternate schedules: The families that are irresponsible, the ones that you really do want to kick off your schedule, are not going to call you. They will remove themselves from your schedule.

A Full Practice Schedule Starts with Good Communication Skills

It’s very likely that your staff will need to improve their communication skills to be able to skillfully manage conversations like these. The more skill, the better the outcomes. There’s so much information that can help you in our Lemonade Library. Get logged in and look for Lemonades on building strong communication skills for both yourself and your staff.

About Diane Crecelius

Diane Crecelius is a physical therapist and founder of a multi-million-dollar, multi-location practice with well over 3,000 visits per week and 200 staff! In the past several years, Diane has worked tirelessly to support Peds-A-Palooza® Community & Conferences and the success of Private Practice Owners. Diane has presented at nearly every Peds-A-Palooza live and virtual conference since the first sold-out conference in 2018. Her extensive knowledge derives from her decades in practice and from being trained and consulted by Survival Strategies, Inc. She uses this training to help Private Practice Owners learn how to thrive and expand while keeping their stress low.