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Acupuncture Today
June, 2012, Vol. 13, Issue 06
 
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A Cancellation Policy Can Help Build a Successful Acupuncture Practice

By Alfie Vente, RMT, D. Ac (Cand.)

Acupuncturists and TCM practitioners must exhibit professional conduct parallel to lawyers, doctors, dentists and other healthcare professionals. This is established through many avenues including regulation, standards of practice, research, clinical success and clinic policies that protect the clinician and the industry as a whole.

The latter pertains to one particular policy that every clinic/clinician should have. This is a written cancellation policy. This policy should be rigid enough to protect one's business and easy to understand so that it lessens the chance of misunderstandings. This policy should be displayed openly in the reception area and a separate one signed by all new patients so that there is a mutual understanding.

If you were to visit many successful businesses in the service and healthcare industry, you will see that many of them have written cancellation policies in the waiting area that is easily read and understood by clients. These businesses have probably been established for a number of years and have a loyal following of customers/patients.

Acupuncturists and TCM practitioners must have written cancellation policies and enforce them. As a registered massage therapist who has proudly worked for one of the largest corporate physiotherapy companies in Canada named Life Mark Health, and currently working for another one, Spine and Sport (owned by the Canadian Back Institute), I will share what I have learned over my 11 years of practice. If you are a practitioner who has reservations about a cancellation policy, hopefully I can reduce any anxiety and encourage you to have one.

These two companies over the years have been successful because they are able to integrate the clinical side and the business side seamlessly. The clinicians of these two companies generally have the respect of their patients.

In general a 24-hour cancellation policy seems to be the norm. I have seen polices that are 12 hours and 4 hours. Regardless of the length, the policy must be adhered to. There are only three extenuating circumstances that I believe the cancellation policy can be less strict. Two of which are deaths of a family member or severe illness/injury of the patient. The last one is more discretionary. This is in the case of a long time loyal patient, who for some reason or another cancels last minute. It should make common sense that leniency should be given to those that have shown strong loyalty to your practice over time.

One of the issues that I struggled with in the beginning was the business side of my practice. I am probably correct in stating that most new clinicians have the same issue. I was tentative to ask for payment, almost to the point of feeling embarrassed to. I had feelings of guilt with formulating a treatment plan and relaying it to my patient because I new that the cost for prolonged treatment was going to be expensive for the patient. Even though, I knew in my heart that the patient required the treatments. I also had trouble with patients who would cancel last minute.

All of these issues are stumbling blocks to a successful and prosperous career. One of the annoying things about being a new clinician is that most of the learning dealing with money and practice management comes from the "school of hard knocks." I have had dealings with owners and clinic directors who were more then willing to take advantage of a "newbie." As the saying goes, "learning is expensive!"

If we were to look at this from a Traditional Chinese Medicine angle, we could look at monetary compensation as a form of qi. We could also look at the individual who has booked that appointment as another form of qi and the appointment booking time as a channel in which the qi travels.

We need qi to survive and if we continually have uncompensated missed bookings, channels(appointments) become vacuous of qi. Eventually if we continue to allow missed bookings without compensation to occur, we start literally paying back with our own qi (we end up paying out of our own pockets for expenses that accrue).

As we know, there will be a limit when qi is deficient and we become depleted. Our goal is to have a constant flow of qi for the work that we do. We are professionals that need to be compensated as professionals.

I have written below a few common reservations with responses to assist you in your decision to have a cancellation policy.

1. I am in the "healing" profession and I don't think it is right to charge someone because they didn't receive treatment.

Answer: You are in the healing profession, indeed that is correct. Being a "healer" and charging someone for a missed appointment are two totally different issues. By the way, your charge is not for the actual treatment, but for the time that was reserved for treatment. It is about how important your time is to you. When you enforce a policy, you relay to the client that you are serious about what you do. What this also does is that it potentially keeps a patient in line with the treatment plan. A compliant patient usually has a successful experience. The cancellation policy motivates compliance.

Think about the patients that you have had over the years and think about the ones, who tended to be inconsistent with their treatments. How many of these actual individuals were you successful with? Now think about the ones who were compliant. I am willing to bet that for the most part, you as a clinician was successful in assisting these patients.

1. Even if I had a cancellation policy, it is still difficult to collect monies owed anyways.

Answer: This is true. Another reason why you have a cancellation policy is that it sends a message of urgency to the patient. Picture this scenario. Patient "A" is told over the phone by the receptionist, "...there is a 24 hour cancellation policy in effect and it would be appreciated by the therapist if you call in advance to cancel. Thank you for booking. We'll see you at 6." Patient "B" is told by another receptionist, "...thank you for booking, we will see you at 6. Have a good day." Which of the two methods would motivate compliance to show up for treatment? Which one would have a patient least likely cancel in the last minute? Obviously patient "A." There is that sense of seriousness and urgency.

Even with this urgency they still may miss their appointment and yes, you may have difficulty collecting but you will reduce the chances of this scenario.

1. I am afraid I may offend the patient if I ask for money. They may go somewhere else.

Answer: By building results through compliance via a cancellation policy, you will gain trust and loyalty. The patient that leaves your clinic for another, has probably had chronic issues with appointments in the past. Your time is valuable. You want patients that will respect your skills and time. From my experience these are the "wishy, washy" patients who seem to go from therapist to therapist.

On a side note, a common "red flag" is when a patient bad mouths a clinic or clinician they have visited and expects you to do more for them or "guilts" you into giving more of your time. A typical scenario is the patient who is late, 15 minutes for their 5 o'clock appointment and asks you, "...oh, do you have anyone else after me?...." It is code for, "I know I was late but can you still give me an hour of your time?" Another version of this is, "...I have nowhere to go afterwards, so you can do the full hour." There are many other versions of this scenario, but I can almost guarantee these patients will be the ones that believe your time is insignificant and will be the least likely to "stick" with the treatment plan.

These are common scenarios in which the therapist convinces themselves to avoid having a written cancellation policy. The unfortunate reality is that the therapist who lacks a cancellation policy probably has a few other common professional mistakes that have led them into a position where prosperity is just a dream.

Are you the type of therapist that:

  • Fails to instruct the patient to rebook.
  • Has a hard time educating patients.
  • Forgets to remind patients of their upcoming appointment either via phone or email.
  • Has a difficult time being the facilitator for the treatment and "allows" themselves to be manipulated by patients therefore providing a sub-par treatment.
  • Believes that all you need to do is put an ad in the local paper and the patients will magically appear.
  • Charge below what is customarily the professional standard in your area.
  • Has a fear of hurting the patient and therefore unable to perform a treatment that may potentially be beneficial, such as plum blossom.

These are some of the behaviors that can be a stumbling block to success. You may only do one of these behaviors, but if you add the lack of the cancellation policy along with a few of these other behaviors, you are probably having a difficult time retaining patients.

If you noticed being a terrible clinician was unlisted. Being a terrific clinician will give you that boost in becoming a successful practice, but even mediocre clinicians can be successful with the proper behaviors and policies in place.

As acupuncturists and TCM practitioners most of the business aspect of practice is learned after school. It is usually a painful experience, but if you implement the proper behaviors and policies consistently over time you will be successful. The cancellation policy is an aspect of practice that the practitioner must adhere to. It sends out a signal to the degree of seriousness and professionalism to the patient. The policy will help in becoming respected like other professionals such as doctors and lawyers.

Below is a short, simple, easily understandable example of a cancellation policy that can be displayed in your reception area:

Cancellation Policy

Thank you for choosing ___________________ clinic. Please contact us at least 24 hours to cancel or reschedule your appointment. We enforce a strict cancellation policy and you will be charged the full amount for your scheduled appointment time if cancellation or rescheduling is less then 24 hours. Thank you for your time and understanding.

You could also adapt this to a form that a patient can sign and it may potentially look like this:

Cancellation Policy

Thank you for choosing ___________________ clinic. Please contact us at least 24 hours to cancel or reschedule your appointment. We enforce a strict cancellation policy and you will be charged the full amount for your scheduled appointment time if cancellation or rescheduling is less then 24 hours. Thank you for your time and understanding.
I _____________________________ (please print name), have read the above policy and acknowledge that I will be charged the full amount and am responsible for payment of my scheduled appointment if I cancel or reschedule with less then 24 hours notice.

Signed(patient signature): _______________________________________________

Date: ______________________________________

This is just an example of a policy. If you have further questions or if you feel you need assistance in regards to your cancellation policy, please email me at .


Alfie Vente is a Registered Massage Therapist in Ontario, who graduated from Sutherland-Chan School and Teaching Clinic. He has been in practice for 11 years and has currently two practice locations. He also taught for 5 years at the Canadian College of Massage and Hydrotherapy as a Massage therapy instructor. He is a therapist at Physiomed's , Flagship clinic and also works at Spine and Sport in Downtown Toronto. He currently is studying in the 1900 hour Acupuncture program at the Shiatsu School of Canada, SSC Acupuncture Institute. With his background he has a unique perspective on industry, education and clinical issues and thus enjoys writing about these particular subjects. You can find more information about himself on his blog at http://alfievrmt.blogspot.com/. You could also email him at .

 

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