Patients going beyond treatment time are the bane of orthodontic practice. We orthodontists bring this ubiquitous problem on ourselves by and large for any number of reasons we have discussed before. It is vitally important to understand how many people in our practices are overtime if we want any chance of minimizing this problem. If you have associates working in your business this is doubly important (at least doubly).

The way we combat the tendency for overtime patients to accumulate is simple but not easy to do consistently because it takes time and effort. First run an overtime report in your software to get an idea of the percentage of overtime patients you have. This is great perspective but it is far to impersonal to make a serious impact. Next, and most importantly, create a spreadsheet and print it out and keep a physical copy in the clinic in a prominent place. The spreadsheet can be composed of anything you like but we use the following:

  • Patient name
  • Start date
  • Estimated completion date
  • Months overtime
  • Reason for overtime
  • How many more visits to finish patient
  • Doctor signature

Every single time we see a patient that is overtime or close, the chair side assistant has the doctor fill out this form in their own hand and sign the sheet. At our end of day meeting we look at the overtime sheet and make sure it’s fully completed and make sure the plans to finish the case are documented in the patient charts. The act of doing this seems redundant and overkill but what you track improves and by filling out this form for every overtime patient you’ll be forced to face the cases that aren’t going well in your practice instead of ignoring them like we orthodontists prefer to do. Not all cases go well – that’s just a fact of life. Our patients are best served when we avoid overtime but it is certainly our duty to focus on finishing these overtime cases.

One final suggestion – if the patient has been in braces loner than 30 months and they will not finish in the next visit or two then it is probably a great time for a braces vacation.

4 thoughts on “A System for Minimizing Overtime Patients

  1. thank you great points. Question: how do you deal with those who missed some appointments or payments, have balance and are in treatment for over 24 months? Lets say they have no money to pay more than their estimated monthly and what to do then? Please advise. Thank youi

  2. Have everyone on autodraft to avoid that situation is the way to go. But no matter what you do you will always have some outliers and with those you have to come up with custom deals for each. You can only plan for what happens 95% of the time and you have to just wing the rest!

  3. thank you. That is been a problem lately with those cases finished “too soon” but that is a good idea to have an associate sign the paperwork for each overtime chart.

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